Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

Tá Teachtaí Dála Shinn Féin ag tacaíocht leis an rún. Molaimid na Teachtaí Neamhspleácha as an rún a chuir os comhair na Dála, atá oiriúnach mar tá Aire nua sa phost. Is mór an trua nach bhfuil an tAire sa Teach, ach an tAire Stáit. The Sinn Féin Deputies will support this motion, even though I am disappointed the Independent Deputies highlighted the case for some hospitals but failed to mention Monaghan General Hospital, which is a glaring omission.

The Government's amendment is insulting. It makes no effort to address even the main issues raised in the motion and repeats the two-part mantra that we have heard ad nauseam of increased spending and the Government's health strategy. It has been amazing to listen to the commentary since the appointment of the new Minister for Health and Children, the leader of the Progressive Democrats, Deputy Harney. One would think the Government's health strategy had only been published last week instead of three years ago. Will the former Minister, Deputy Martin, be air-brushed out of history?

A prime example is the speculation that the new Minister might be the one to take on the consultants. The consultants' contract was supposed to have been renegotiated two years ago under the Government's health strategy. In the section entitled Acute Hospital Services, the strategy promises that "greater equity for public patients will be sought in a revised contract for hospital consultants". The target date for agreement on that revised contract was the end of 2002. Last year the then Minister for Health and Children, Deputy Martin, told me that only preliminary talks had begun. The new Minister, Deputy Harney, is aware that even those preliminary talks are, to all intents and purposes, postponed indefinitely. The consultants have doggedly refused to proceed until the insurance cover dispute is resolved. The consultants' position is unquestionably an obstructionist tactic.

The Minister, Deputy Martin, described the consultants as kings in their own domain. This was a very strong statement but the words have not been matched by actions. We have not heard the Government's position in the negotiations. It should at least demand that all new consultant posts be entirely in the public system, as recommended in the Brennan report. There must be real accountability from consultants for work in the public system. If the Taoiseach and the Tánaiste are not prepared to do this and to weather the storm, there can be no real health reform — I believe the Minister of State, Deputy Brian Lenihan, who is present, accepts that.

As the motion states, the Tánaiste and Minister for Health and Children has stated that she wants "a health service that is accessible to every citizen, regardless of their wealth". If that is the case, we need to hear the Government's plan for ending the two-tier apartheid system whereby wealth buys access to what can only be regarded as excellent private care while the public system and the public patient are lagging way behind. The Progressive Democrats Party was nearly as extravagant as Fianna Fáil in its pre-election promises although it did not promise 200,000 extra medical cards. It pledged, however, to "ensure income eligibility criteria would at least keep pace with movements in incomes". That has not happened. Some 100,000 fewer people have medical cards than was the case in 1997 when this relationship was first launched.

The Progressive Democrats also made a commitment to "ensure regional cancer care centres are established so that patients do not have to travel 100 miles for ongoing radiotherapy". It declared: "This will be an immediate priority for us." The Tánaiste must fulfil that promise and she will have the support of all opinion if she earnestly pursues and delivers on that. She should ensure that promise will mean not only that the additional centres that have been signalled will be established but also all the others that have been argued for, in Waterford, Limerick, Letterkenny and so on. She should not neglect, as many others have failed to mention, the needs of the north east, north of Dublin and to the Border, which is repeatedly forgotten by many commentators.

I tabled a series of questions on this issue before notice of this week's Private Members' business was given. I am sorry the Ceann Comhairle has vacated the chair, but he disallowed most of my questions although, inconsistently, he allowed others, including one in another Deputy's name, which also addressed cancer services. My questions were specific and did not anticipate the Private Members' business of the Independent Deputies, of which I had no knowledge. I regret that most of my questions were disallowed this week.

Before he left office, the former Minister for Health and Children, Deputy Martin, met personnel in the North Eastern Health Board and issued a public statement about hospital services in Counties Monaghan and Cavan. I tabled a question asking the Minister to confirm that statement and the promised measures, and to put a timescale on their delivery. On the basis of the answer I received, I can only conclude that much of what the former Minister announced is already unravelling. The Minister, Deputy Martin, promised a CT scan for Monaghan General Hospital but the new Minister makes no mention of it in her reply. Is it still on the agenda? The Minister, Deputy Martin, spoke of the immediate recruitment of five junior doctors for the same hospital but the new Minister simply states that the board proposes to recruit these five doctors to facilitate the early restoration of around-the-clock medical cover. The Minister, Deputy Martin, spoke of an emergency room to be provided at a cost of €1 million. A week later, the new Minister speaks of a treatment room — there is a difference — with Government funding of €750,000.

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