Donie Cassidy (Westmeath, Fianna Fail)

I became a member of the Midland Health Board in 1985, when Deputy English was still in school. The board faced a difficult situation in that year and the challenge increased in 1987. In 1988, when the Ceann Comhairle was Minister for Health, we put our estimates through on Holy Thursday. All of us in public life at that time, including Deputy James Breen from Clare who is here today, can well recall that protective notice was given to a significant number of health workers throughout the country. There were queues of cars outside my home that night, containing staff from the local hospital, St. Peter's Hospital in Castlepollard, upon whom protective notice had been served. It was evident that there was a significant problem in the health service.

The difficulties now experienced by the sector are nothing as compared to the situation in 1987, 1988 and 1989. There are young people in this House today who do not remember bad times. The difference today compared to those earlier years is that there were then no resources to address the problem. The resources are now available, if resources are the difficulty. The difficulties experienced in the 1980s and early 1990s by nursing staff, those who ran our health boards and by the unfortunate patients who bore the brunt of these difficulties were tremendous.

As a member of the Midland Health Board for 18 years, I acknowledge the public representatives of all political persuasions who served on that board and selflessly gave of their time to ensure we can enjoy the health service we have today. I also served as a member of Westmeath health board and health advisory committee, which used to run the health service before a former Deputy from my constituency and former President, Mr. Erskine Childers, established the health board system during his time as Minister for Health.

In view of the long track record of difficulties in this area, we now look forward with confidence because the resources are there to solve those difficulties. The transparency issue is the most significant challenge facing the Tánaiste. We all know there are difficulties in the health service. Since 1997, the allocation of funding to the Department of Health and Children, which has increased three-fold, has not solved the problem. All Members are anxious to know why this approach has not worked. The Tánaiste has only begun her Ministry at the Department and it will take a little time for her to get her bearings. Some Members of this House are health sector professionals. I call on them, from all sides of the House, to assist the Tánaiste in the dilemma in which the Government finds itself.

There are positive elements to be welcomed. In the midland area, the MidDoc facility which provides a 24-hour doctor service is working very well. Some weeks ago, my grandson succumbed suddenly to a virus and we availed of the MidDoc service in Mullingar. He was seen within ten minutes. This is the treatment every child deserves. It is a terrific service, replicated in other parts of the country through WestDoc and so on. I compliment the previous Minister who established it and everyone in the health services involved in its delivery. Mullingar General Hospital has acquired a new consultant and a new accident and emergency unit. I attended this unit recently on account of treatment required by my mother and there were 18 staff employed there. Positive advances such as these are seldom mentioned.

However, I observe that there is a hospital building in Mullingar which has stood idle for more than ten years. I invite the Tánaiste to visit Mullingar General Hospital and Longford-Westmeath General Hospital to see the great State asset there, ready to be fitted out for the increased demand that exists in the midland area. The national spatial strategy incorporates Athlone, Tullamore and Mullingar, while Longford and Portlaoise are designated hubs. We are told that the populations of these towns will grow from approximately 20,000 to some 60,000 over the next 15 years. The critical mass for the area as a whole will be 350,000, which represents a significant number of patients.

Longford-Westmeath General Hospital is the only acute hospital between Dublin and Sligo. That is a long distance. In 2002, there were 1,600 births in the maternity unit of Mullingar General Hospital. This increased to 1,800 in 2003 and the number will be in excess of 2,000 for 2004. The hospital provides a fantastic service, with excellent nursing staff and a great medical centre for the two counties. However, funding should be made available at the earliest opportunity for the additional wing that is standing idle. It defies logic that it should be built but not utilised. The two old wings for male and female medical patients in the hospital in Mullingar were built of mass concrete in the 1930s, during the tenure of my predecessor, the former Minister of State at the Department of Health, the late Mr. M.J. Kennedy, with whom I am honoured to have been closely associated.

I came to this House as Mr. Kennedy's assistant in 1962. In the more than 40 years since, I have seen many changes. There has been significant improvement, most of it under the jurisdiction of Fianna Fáil and our partners, the Progressive Democrats. I also acknowledge the work done by the Opposition parties in this area over that 40 years. We have come a long way, even in the last 15 years. Some 40 years ago, there were areas with no running water or sewerage systems. All fair-minded people will agree that we have transformed our country. The visit of the late United States President, Mr. John F. Kennedy, was a turning point in our history.

We are here as Oireachtas Members for a short time in order to serve the people of the counties which we represent, whether it is Tipperary, Clare, or the maroon or white of Galway or Westmeath. Having considered the various difficulties and challenges that Members have experienced in different portfolios, the health service represents the most significant challenge I have seen in my 40 years coming to this House, whether as assistant to Mr. M.J. Kennedy or as a Member representing the people of Westmeath. There has been much repetition in the commentary about this Bill. I officially invite the Tánaiste to visit the asset that exists in Mullingar. I also invite her to visit one of the country's worst senior citizens' long-stay units, St. Mary's care centre in Mullingar. Much of this facility is closed due to the difficulties experienced there. It has a fantastic nursing staff with a great commitment to caring for the elderly. My late father died as a patient there. The design team has been appointed for it and I am committed in my support for the facility.

The design team has also been appointed for work to be carried out to the Longford-Westmeath General Hospital. Under the programme of care for the elderly, there is the possibility that every senior citizen would live no further than 15 miles from a long-stay care unit or a general hospital. I look forward to a new 50-bed unit in Castlepollard being built, I hope during the term of this Dáil. Perhaps the building of that unit could be provided under a public private partnership process. I do not see why it could not be. While the proposed unit will be small, it will make a great difference to the lives people living in the rural areas in the vicinity of it.

Two major challenges face senior citizens living in rural areas, one of which is loneliness. As a former postman, I know about the experience of loneliness from having visited people living in the remote areas. The postman might be the only person these people meet in the day. The second challenge facing them is the issue of security, which is a serious problem for people living alone in rural areas. We all represent people from rural areas, although Deputy Woods might be a little more fortunate in his constituency in Dublin, but as a former Minister he is aware of the difficulties faced by people living alone and worrying about their security. There have been cluster developments such as those in Carnew and Mulranny, the latter in which Deputies representing Mayo have been involved. As public representatives, we can make an immeasurable contribution in this area.

I am associated with the North Westmeath Hospice Association, of which my wife is chairperson. It is appalling that the Department of Health and Children and the Government do not pay the nursing staff who visit people suffering from the plague of cancer and allow those suffering to die with dignity in their own homes. It is appalling that people must fund-raise morning, noon and night and friends of those being cared for must give back their wedding presents to ensure that these nurses are paid, even though it involves only two or three nurses in each county. I do not suggest we should interfere with the hospice regime of fund-raising, but perhaps the Tánaiste would examine the possibility of paying the wages of the nurses who call to these unfortunate patients who are suffering in their homes. Such care gives them the dignity of seeing the end of their days at home. This is an issue that should be addressed soon.

People ask me about the good old days, but everyone agrees that the good old days are now. It is a wonderful time to be in public life. Representatives can achieve a great deal for the people they represent because resources are available. Those of us who are Members of this House or the Seanad, as I was for 20 years, saw the dreadful drift of people from the land and the heartbreak of mothers and fathers who reared their sons who then left to benefit the economies of other countries. Through my other line of business, I visited hundreds, if not thousands, of sons and daughters of friends in Sydney, New York and London who faced the prospect of going home to a flat at night in which there was no one and the alternative was to go to the public house. That does not happen any more. One can be born in Ireland, be educated well, get married, live in a brand new house with one's spouse and rear one's family here. Such opportunities have not existed for our people for hundreds of years. They exist now at a time when we are all Members of the Oireachtas and Deputy Harney is the Tánaiste and Minister for Health and Children.

I do not want to be repetitive or long-winded, but I wish to make the point that the unsung heroes of our society are the carers of Ireland. The daughters and sons who give up their jobs to look after their mothers or fathers get a raw deal which is despicable. Will the Tánaiste use her influence to address this issue? If a son or daughter returns home having left his or her place of employment, he or she should be given the necessary incentives to address his or her needs. If one has a parent in a nursing home, and I have personal experience in this regard, a stay costs anything from €500 to €1,000 a week. That said, the care and attention people receive is magnificent. However, there is not a parent in a nursing home who would not want to be in the four walls of his or her home and have a son or daughter look after him or her. At present, the system does not allow that to happen. I appeal to the Tánaiste as a caring person, which I know she has been all her life as well as a good family person, to address this issue in some way, if not in the budget given that there may not be the time to make such provision, in the Finance Act early next year.

I wish the Minister well in her portfolio. I also wish the Bill well. I congratulate all those who have taken the health system to where it is today. I pay tribute to their hard work and dedication because to be a nurse or a doctor is to have a true vocation. Many people make that unbelievable contribution of looking after those who are sick and not able to look after themselves. The greatest gift the good Lord could give any of us is to have our health. We are privileged people to be able to make this contribution on behalf of our constituents.

I hope the Tánaiste will visit the people of Mullingar, Longford and Athlone in early January because these areas are in need of investment. There is massive road expansion in those areas and it will be followed by the provision of services and a growth in population. Anyone who saw the figures for the number of students attending third level education will have realised that Laois, Offaly and parts of Westmeath have the lowest figures in the country. The question must be asked why that is the case. The reason is simple; it is a matter of resources. The midlands is getting a chance for the first time to have proper roads, namely, a motorway from Kilcock to Kinnegad and a dual carriageway from Kinnegad to Mullingar. Work will commence next May on a dual carriageway from Kinnegad to Athlone. The sum of €1 billion is being spent in the midland counties which have never received such a level of investment. The sum of €218 million is being spent on sewerage schemes in Westmeath this year. It is a good time to be in public life. I wish the Bill well in its passage through the Houses and wholeheartedly support it.

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