Noel Grealish (Galway West, Progressive Democrats)

I am delighted to have the opportunity to speak on this motion. I support the Tánaiste and Minister for Health and Children in her current endeavours to reform our health service. I had the pleasure of accompanying her as she visited University College Hospital, Galway, this week. There she met management and staff and saw the facilities at first hand. On the day of her visit, there were 14 patients waiting on trolleys. To me, as a local public representative, that is unacceptable. It is unacceptable to the Minister and she is determined to ensure the service is improved and that this country enjoys a health service to which we can all gain access and of which we can be proud.

The considerable goodwill of the public and the acceptance of the challenges that the Minister faces were very evident during her visit to the hospital. People know that she is not the reason they are waiting in accident and emergency units. She is not responsible for patients being left on trolleys and they trust her when she says that reform will result in improvements and make a real difference to patients. They accept that she cannot do it over night. However, if there is any politician in Leinster House capable of really delivering, it is she. Her success, the pace of reform and the number of improvements will depend on the level of cooperation she manages to secure from politicians, consultants, all health care workers and the private sector.

The privately run Galway Clinic, which is in my constituency of Galway West, announced yesterday that it is to open the country's first private accident and emergency clinic in February. This is a ground-breaking development and should be welcomed warmly. It is the sort of initiative from the private sector that needs to be replicated right across the country. The State cannot shoulder the whole burden of the health service and there is room for the private sector to come on board.

The accident and emergency facility at the Galway Clinic will operate on a limited basis initially, with patients being referred by their GPs. However, it is hoped to expand the service to a 24-hour walk-in service as quickly as possible, with new staff being employed locally and from abroad. This initiative will remove pressure from the accident and emergency facilities at other hospitals in Galway.

The Galway Clinic also provides other vital services for public patients in the Galway region. Before Christmas, after a series of negotiations with the Western Health Board, the clinic made arrangements to treat cancer patients in the west until such time as the new radiotherapy unit is up and running in University College Hospital, Galway.

Many areas of the health service need reform. A very positive step was the abolition of the health boards and the establishment of the Health Service Executive. Other areas now need to be tackled, particularly accident and emergency services, because accident and emergency units represent many people's first and only contact with the health service and form their impression of the state of that service.

It is true that more than 70% of people who seek treatment at accident and emergency units do not require admission. Clearly, if we can encourage more of these people to visit their GP before attending accident and emergency units, we will be part of the way towards providing a solution to the problems associated with accident and emergency services. The Minister has identified improving access to GP care as a priority and that is why her announcement of 200,000 GP only cards and an additional 30,000 medical cards represents a sane and sensible response.

Traditional approaches to solving problems in our health service have been tried and failed. They have been failing since the 1970s while the cost to the Exchequer has continued to rise. The Minister, true to her style, is taking a different approach. Why continue to make the mistakes of the past? The GP only cards will encourage thousands of families throughout the country to visit their GPs instead of their local accident and emergency units when seeking treatment. They will relieve pressure on our overcrowded accident and emergency units.

Another such move contained in the Minister's ten-point action plan is the development and expansion of minor injury units, chest pain clinics and respiratory clinics in hospitals to relieve pressure on accident and emergency departments. Such units will offer treatment to patients requiring more than standard primary care from their GP, but not emergencies in the true sense. For years, we have been encouraging people to keep accident and emergency units free for real emergencies. The Minister is now putting in place real structures to ensure patients will have real alternatives to accident and emergency services.

The Minister is also increasing out-of-hours GP services to keep people's need to attend accident and emergency departments to a minimum. In doing so, she will need the cooperation and assistance of GPs on the ground. If a person has no access to a GP in the evening or at weekends, he or she has little option but to visit accident and emergency units.

I pledge my full support to the Minister in her endeavours to improve the health care system. The vast majority of people were very pleased late last year to hear that Deputy Harney was the new Minister for Health and Children. They recognise her as a woman of action and as a committed and caring politician. A few days after her appointment, she described the overcrowding in our accident and emergency departments as unacceptable and said conditions would improve. She has brought forward a ten-point action plan and has secured additional revenue, which will be spent wisely and make a real difference and not disappear into a black void, as happened in the past. She is working to improve the health service. It will improve, and patients will very soon begin to see the real changes.

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