Brian Lenihan Jnr (Dublin West, Fianna Fail)

Yes, it can be dealt with on Committee State as it is a committee point.

A contention was made that this Bill would not provide for extra services. The Bill is concerned with reform of the organisation and management structures of the health service. Regarding extra services, only last week the Tánaiste announced an increase of €950 million for health in the Estimates, bringing total spending on health to €10.5 billion, an increase of 9.9%. This funding will provide for more and better services which will be more effective because of the reform programme.

New units in hospitals will be opened and cancer services expanded. Waiting times for patients will be further reduced by additional funding provided to the national treatment purchase fund. Some 1,000 new front-line staff will be recruited next year to provide services to people with disabilities. Some 300 new beds will be available in public hospitals next year, in addition to those in the new acute medical units. The new management structures will support these extra services and increase their efficiency and effectiveness, which will deliver increased patient satisfaction and better outcomes.

I cannot agree with Deputy McManus's proposal that a national hospitals authority be established to deal with the hospital sector, and health boards be established to deal with provision of community care. This would inevitably lead to less co-ordination of services and this lack of co-ordination between the services has been the cause of numerous complaints over recent years. We are seeking, through the establishment of the executive, to move to a more co-ordinated service, not a less co-ordinated service. That is why one of the requirements being placed on the executive, under section 7, is the integration of the delivery of health and personal social services. I have previously considered the issue raised by Deputy McManus, which seemed a proposal worthy of examination. However, the general medical service, the primary care service and services for persons with mental health difficulties are all based in the community, under the authority of the health boards. It is difficult to draw the line between what happens in hospital and what happens with regard to health services in the community. For those reasons, the Tánaiste and previous Minister took the view that the best course of action was to have a unified administrative structure, encompassing the various health and social services.

I must clarify the issue raised by Deputy McManus regarding the filling of 22 posts by the health boards since March of this year. As the Tánaiste pointed out in her reply to Deputy McManus's parliamentary question, the 22 posts approved are either key management posts for the delivery of patient services or concern important areas of health services. It was considered necessary to fill these posts for the maintenance or the continuity and quality of service provision in the health services, in the context of the transition to the new administrative structures.

This is the first comprehensive reform of the structures of the health service for more than 30 years. It is not a reform that is being entered into lightly. The studies which were undertaken to arrive at the recommendations in the reform programme have been outlined to the House. Following the announcement of the reform programme, a comprehensive communications and consultation exercise took place to inform all those involved in or affected by the proposed reforms.

The Bill before the House represents a culmination of that process. It represents the beginning of a new era in the management of health and social services. We have had the opportunity with the legislation to put in place a modern and effective organisation and management structure which will provide for a health service to meet the needs of those who live in our country in the 21st century.

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