Brian Lenihan Jnr (Dublin West, Fianna Fail)

I thank the Deputies for their contributions on this important legislation. The Tánaiste pointed out in her opening speech that the legislation provides for the complete reform of the organisation and management structures of our health services — the first substantial and fundamental reform for more than three decades.

We do not accept that the legislation is being rushed through the Houses without consultation. The Government announced the reform programme 18 months ago and the need for this legislation has been well signalled in the intervening period. This Bill is the second of two Bills to be brought to the House this year in regard to the Government's plans for structural and organisational reform of the public health services.

As recently as April and May last, the House discussed the Health (Amendment) Bill 2004. As Deputies will recall, it was an interim measure to fast track the reform programme. That 2004 Act is part of the legislative arrangements necessary to underpin the reforms. In that context, the then Minister went into considerable detail about the reform process and the arrangements to be put in place going forward. He specifically informed the House of plans for further legislation, such as that before us, which would: establish the Health Service Executive; make provision for improved governance, accountability, planning, monitoring and evaluation; introduce a statutory framework for the handling of complaints and provide for democratic participation at regional and local levels under the new structures. The Government is not springing any surprises on the House under the Health Bill 2004. The changes involved have been well explained and communicated publicly and have been specifically previewed in this House.

Communications and consultation have been at the core of the health reform process going back to the national health strategy, Quality and Fairness, in November 2001. Immediately after the Government decision on the health service reform in June 2003, the Secretary General of the Department briefed political parties on the proposals.

From the beginning, the process has involved an open discussion. The Prospectus and Brennan reports were published in June 2003 and laid before the House. At that time, 100,000 copies of an explanatory booklet entitled The Health Service Reform Programme outlining the reforms were issued, especially to those working in the health system. The then Minister for Health and Children, Deputy Martin, and the Secretary General of the Department visited each health board area to meet and discuss the reforms with the staff. Simultaneously, an extensive consultation and communication process was under way.

Following this initial process, the Department commissioned the office for health management to conduct an information and consultation exercise reaching as many people and agencies as possible. More than 20,000 staff were directly engaged over the summer months and into September 2003. This included staff and representatives of the ERHA and health boards, the voluntary hospital and disability sectors, the community and voluntary pillar, the trade unions and the Department of Health and Children itself. The office of health management produced a detailed report of this process that was published earlier this year.

The meeting of the national consultative forum in November 2003 focused on the health service reform programme. Other communication and consultations included publications on the health reform website and steps taken by the interim Health Service Executive to inform health service staff of developments as they occurred.

It is inaccurate to state that this Bill does not provide for accountability by the executive. A key objective of reform in the health system, as identified in the Prospectus and Brennan reports, involves the separation of policy and operational responsibilities. The result will be greater clarity, transparency and accountability around who is responsible for doing what in the health system. The establishment of the Health Service Executive, as a single entity with statutory responsibility for the management and delivery of health and personal social services, is the central plank in this important process.

The Tánaiste is very strongly of the view, as am I, that the executive should be as widely and directly accountable as possible for its decisions, plans and actions in regard to its statutory functions. Such an approach is central to ensuring the highest standards of service are achieved and maintained. It is the Tánaiste's intention that this should be reflected in the quality of service that the executive will provide to Members of the Oireachtas in responding to queries and providing information about the management and delivery of health and personal social services, whether at national, regional or local level. This is an important aspect of the executive's work and represents a key element of the vibrant, high-quality customer service arrangements required.

In that context, the executive must establish an effective system of rapid response to inquiries from politicians and the public, establishing systems capable of reaching down into the organisation and rapidly retrieving the necessary information from the authoritative source. This is only one of the potential benefits of streamlined administrative arrangements under the reform process. It is an aspect in which both the Tánaiste and I have a particular interest, not just in the context of the Bill or as a Minister or Minister of State, but as a public representative.

Deputy Ring asked what form the answer to a parliamentary question will take in the future. There will be no change with regard to the practice of parliamentary questions. As matters stand, it is frequently the case that the Minister for Health and Children refers the questioner to the chief executive officer of the relevant health board.

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