Dan Boyle (Cork South Central, Green Party)

I commend the Members of the Technical Group for tabling this timely motion. It is timely not just in terms of the changing Cabinet, which sees the Tánaiste take over the Department of Health and Children, but because an ESRI seminar was today presented with a paper which compares the Irish health service to other economically developed countries. To be told by a think-tank, which is well respected in this country, that we are rated 21 out of 22 health services in such countries is a shame and should be an embarrassment to the Government. The Tánaiste has the comfort of knowing that she is beginning her term of office as Minister for Health and Children in the knowledge that, as far as the Irish health service is concerned, it is closer to Boston than Berlin. The only country which has a lower rating is the United States, where almost half the population has no health insurance and where the name of the game in terms of receiving any health care is the size of one's wallet. This is the direction in which the Government has been going for the past seven years and I fear the Tánaiste will lead us further in that direction.

If we are looking for a metaphor for the state of the Irish health service in 2004, we should look at a "Six-one" news report last week about the ambulance service on Aranmore Island. Aranmore Island was my father's native home where he had a fatal attack and died four years ago — I referred to it in the House in the past. At the time the ambulance was out of order and my father's last few hours were spent in the back of a trailer before being taken to a lifeboat and then to Letterkenny. As I explained to the Minister's predecessor and the CEO of the North Western Health Board, I do not think it was a factor, but it certainly did not lead to the dignity which should be afforded on such an occasion. When I saw last week's news, I discovered that four years on the same ambulance is now out of commission for one year. I saw the dilapidation of the vehicle, with a 1992 registration, which is nothing more than a rusted hulk, with nothing in its interior to justify calling it an ambulance. I saw the Irish health service represented as it truly is, and this is the morass the Tánaiste must seek to tackle.

Another note that struck me in this Breast Cancer Awareness Month and the series of advertisements being run on radio and television to encourage women to be more aware of the scourge of breast cancer is the rider "breast check is not available in the south and west of the country". What kind of Government can promote such a partial service which ignores the needs of so many of its citizens?

What really worries me is that in taking up her new office and saying all the right things in terms of what she thinks people want from the health service, the Tánaiste is coming into office with several pieces of baggage vis-À-vis the way in which her party has affected how the health service is run. We recently saw the opening of a private hospital in Galway. It was the first hospital to benefit from the tax incentive in the 2003 budget. Those who invested in such a hospital are getting from taxpayers tax relief of 42%. I read that most of the custom of that hospital — it is custom because it is being run on a profit basis — will come directly from State sources by the State transferring patients who should otherwise be treated in a public hospital system through the national treatment fund. This is privatisation on the double because it includes tax relief, plus the State paying for the privilege of treating its citizens without having a properly funded public health system. What sort of madness has brought about these types of policies?

I am sorry the Tánaiste is not here to respond to the debate. I hope she will do so over the course of tomorrow evening. This is no white horse affair, it is rescuing a health service which has been downtrodden for several decades. We do not have a health service. We have bits and pieces where people have to make do. Their health and the quality of the health care they receive subsequently depends on who they are, where they live and the resources they have. Until the Government and the Minister are prepared to address these central questions, I fear we will not reach the ranking of the countries listed one, two and three on the list supplied today by the ESRI. I also fear that a subsequent report will rank us below the United States, in 22nd place.

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