John Moloney (Laois-Offaly, Fianna Fail)

I make the point only because I have been goaded by Deputy Durkan. Where services were agreed and funding put in place, is it not ironic that a member of the then Government party challenged a decision purely because of pressure brought about by the home county? I regard this Bill as a means of escape from that type of pressure.

I reject criticism that there has not been consultation on the Bill; there has been. There is little point in having medical representatives on health boards if medical advice is ignored when it is called for. I am often amazed when a public representative's advice is taken over and above that of a specific medical adviser, as I instanced previously.

I welcome that so much has been provided, not just last year and the previous six years but specifically for this year. I congratulate the Tánaiste on securing a further increase in the level of funding. There is a 9% increase in the Estimates this year. All that will go towards the provision of specific levels of service. The total spend in 2004 will be €6.58 billion or 188% higher than in 1997. When a challenge is put as to where the money is going, people want to ignore the facts of extra nurses, frontline services and speech therapists across all the specific headings. The Government has provided €6.2 billion in increased revenue funding over several years. This is 185% of the 1997 figure of just under €3.4 billion.

This extra investment has brought about significant results, including record levels of activity in the acute hospital system, with a range of additional services provided across all care programmes. One way the success of a hospital service delivery programme may be gauged is in its throughput of patients. More than 1 million day care patients were discharged in 2003, an increase of 43,000 or almost 5% over the 2002 record. I do not deny that figures may be produced to put the best slant on a particular case. However, patients cannot merely be passed through the front door and out the back door of a hospital for cosmetic reasons. The reality is that these figures are genuine.

There has been a substantial increase in day cases of more than 190,000 or 76% since 1997, to give a total of almost 441,000 at the end of 2003. I see this Bill as vindicating the decision to support the level of investment in terms of revenue and capital as well as the throughput of patients and the newly recruited medical personnel. I welcome what the legislation contains and recognise its possibilities and benefits.

Perhaps the people who condemn this initiative most are fearful that the health issue might be removed from the national agenda leaving them with little to criticise. However, I prefer to look at the larger picture and accept that they are concerned, as are all Deputies on the Government side, to ensure the people of this country secure a health service of which we can be proud.

The final cornerstone has been put in place. The capital programmes exist and there are few main county towns which have not enjoyed substantial investment. We are about to see changes in the style of delivery, performance and responsibility. I welcome everything in the Bill and look forward to supporting every part of it as it proceeds through the House.

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