Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

The Tánaiste's comments, which are an example of pure Progressive Democrats ideology, have been reflected in several pronouncements made by her and her colleagues, indicating a growing trend towards the privatisation of the health service. As I have said, her statement is built on a falsehood. She spoke of Dublin's hospitals as if they are private institutions funded and run independently of the State. The taxpayer pays the hospitals' capital funding, running costs and staff remuneration. It is pure deception to pretend that is not the case.

The Government is trying to have it both ways. It is attempting to claim credit for significant and essential increases in Government spending on the health services over recent years while at the same time absolving itself in a Macbeth-like fashion of any responsibility for the delivery of such services. Those who pay tax are entitled to expect that their basic health care needs will be met by the State, as are those whose incomes are too low to pay tax, including people earning low fixed incomes. People who have been paying tax and social insurance for many years have entered into a social contract. Does the Tánaiste and her colleagues propose to renege on that contract?

I will discuss a specific case with which I am familiar. Accident and emergency services have been axed at Monaghan General Hospital, like other local hospitals. The Minister's predecessors in this portfolio, Deputies Cowen and Martin, claimed repeatedly that they could not intervene to prevent the axing of services. Monaghan General Hospital lost maternity and paediatric services before accident and emergency services were axed. I give credit to the remaining staff of the hospital for the fact that the services we have today can survive.

It appears that the Tánaiste as Minister for Health and Children can intervene directly and swiftly when it suits her to do so. I have asked her a number of questions on this matter and I have written to her about it. I await a response and an explanation. The Tánaiste made an unexplained intervention in the case of two suspended consultant surgeons at Cavan General Hospital. She has yet to explain why she lifted the suspensions. Many people consider that she took such a step to prevent legal action, which she had been advised would go against the State. There are all sorts of possibilities within the wider equation in all of that issue, but I think it represents blatant double standards. Intervention has been ruled out as not being possible, but it seems that an intervention can be made where there is a particular agenda or need. It does not balance out. I demand once again the restoration of the accident and emergency and maternity units at Monaghan General Hospital. I ask the Minister to address the difficult situation that maintains in surgical services at Cavan General Hospital.

The Department of Health and Children released figures last week showing that hospital budgets have been cut by €7.5 million under the punitive system that involves the budgets of so-called "inefficient" hospitals being cut and allocated to other hospitals. The north-east region, in which I live, has suffered more than any other region, proportionately. Hospitals in Monaghan, Cavan, Navan and Drogheda have suffered budget cuts of more than €1 million. When the extra funding for Louth General Hospital in Dundalk was taken into account, the net loss to the hospital services in the north-east region was over €650,000. The Minister is effectively punishing patients for the alleged inefficiency of hospitals and plunging struggling hospitals into further trouble. The north-east region is suffering more than any other region in proportion to its population. Monaghan General Hospital has seen service after service taken away from it and its budget has now been cut by a staggering €368,606 because the Minister has deemed it inefficient, yet she and her colleagues have presided over the removal of all those services, thus creating the crisis in which the staff of that hospital must try to operate and provide the limited services that are on offer today.

The funding of Cavan General Hospital, which has had to cope with the displaced Monaghan patients after the closure of Monaghan maternity, paediatric and accident and emergency units, is also to be cut by a staggering €346,384. Two of the hospital's consultant surgeons were suspended over a period. The Minister has recently lifted that suspension but neither of the surgeons has been allowed to resume his duties. There are so many questions to be asked and so much yet to be exposed.

The staff working in both Monaghan General Hospital and Cavan General Hospital have been heroic in their efforts to cope with the health care needs of the region in the face of Government neglect. This has included cuts in services as well as the State-wide shortage of nurses, the underprovision of acute beds and the ongoing problems associated with the deployment of consultants.

Is it fair and in the interest of patients for the Minister to deem certain hospitals inefficient, cut their budgets and award the funding to other hospitals? If one considers the beneficiaries of this funding, one will note that they are, by and large, larger hospitals throughout the State. Such a system is more akin to that under which bonuses are awarded to and penalties imposed against production managers in factories and other employment locations than to a health system. This is another indication of the much-favoured approach of the Minister and her party colleagues. This approach to health care and hospitals must stop and should be scrapped. Hospitals and patients should not suffer because of the inability and inefficiency of Government and the Department in terms of allowing for the provision of key and critical services. I appeal to the Minister to scrap that particular annoyance.

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