Liam Twomey (Wexford, Fine Gael)

As this will be my last contribution during this session, I wish the Ceann Comhairle, the Minister and his colleagues, all other Members and staff in both Houses of the Oireachtas the best for the summer.

By the time Members return from the recess in September, a year will have passed since my appointment as Fine Gael spokesperson on health and children. Next September, when Members look back at the issues raised during the preceding 12 months, they will include the illegal nursing home charges, which has been a major issue and is still unresolved. They will include the crisis in accident and emergency services and the fact that the Tánaiste's ten-point plan is neither resolved nor even half way to implementation. The issues will include the nursing home crisis affecting Leas Cross and other nursing homes. An independent inspectorate to monitor these homes has still not been established and no legislation to so do will be available when the House returns. Other issues will include the availability of medical cards and the cleanliness of hospitals. Another issue, which has been significant for Deputy McManus as Labour spokesperson and I, is that of ministerial responsibility as highlighted by the Travers report.

In some respects, the problems which have arisen are indicative of the fact that only one piece of primary legislation has passed through this House since I was appointed as Fine Gael's spokesperson on health and children. That legislation concerned the establishment of the Health Service Executive. Subsequently, three amendment Bills have been presented. The Bill before the House is the third such health-related Bill although in reality, it is only the second, as one of the others was rejected by the Supreme Court, obliging the Government to re-introduce the same legislation after Christmas. In effect, this is only the third piece of health-related legislation with which this House has dealt.

In the course of his speech, the Minister of State laid out many important issues as far as this legislation is concerned. However, it is disgraceful that in legislative terms, this is all we have to show for a 12 month period, as far as the health services are concerned. I have just checked the proposed health-related legislative programme and the Government set itself low targets for this year. Its only planned legislation was the proposed Irish Medicines Board (Miscellaneous Provisions) Bill to amend the Misuse of Drugs Acts 1977 to 1984, the Irish Medicines Board Act 1995 and the Control of Clinical Trials Acts. As far as health legislation is concerned, that amendment Bill was the only target which the Government set itself for this session and it never reached the House. The purpose of the proposed Bill was to allow paramedics to administer drugs in ambulances. The Tánaiste and Minister for Health and Children, Deputy Harney, informed the House that the Hanly report is alive and well and will be implemented. I have always asserted that the Hanly report is not implementable in respect of acute services. This legislation was to allow paramedics to administer life-saving drugs in an ambulance and has not even been introduced for discussion into the House in a full year. That is a shocking indictment of this Government's basic attitude towards the health services from a legislative perspective.

The Bill now before the House was only published yesterday. That practice is becoming quite common because if I recall correctly, the Health (Amendment) (No. 2) Bill 2004, which was subsequently thrown out by the Supreme Court, was also published the day before it was discussed in the House. Fortunately, the legislation being debated today is straightforward and the proposed changes are simple. The consequences may be broader, but the legislation itself is quite basic. It is unbelievable that from a legislative perspective, a debate on the establishment of the Health Service Executive has been the only substantive work done in the House. I do not recall it to have been a broad debate. Given that the debate took place as I began my role as Fine Gael spokesperson on health late last September, the legislation was introduced literally weeks before the establishment of the Health Service Executive on 1 January 2005. In other words, it was another vital piece of legislation that was rushed through the House.

Will it be the same next year? What legislation requires discussion in this House? One measure of which the Minister of State is aware is the proposed pharmacy Bill, which is going nowhere. The proposed medical practitioners Bill to review the Medical Practitioners Act 1978 is going nowhere. The Nurses Bill is going nowhere. There are many vital Bills relating to how the health service is run and we have not spent as much as an hour on debate. Everyone outside the House believes the health service is very important. How can they take the Government seriously regarding the concerns they raise about the health service if we spend so little time in our role as legislators debating the issues? I hope we will see a much more productive period regarding the health service in the House in the year starting in September 2005.

Much is spoken about reform and making life easier for the people with whom we deal by delivering a better service. I could talk all day about all that has happened with the HSE since its establishment on 1 January. The chief executive of that organisation has only been confirmed in recent days and so far nothing indicates that it represents a great reforming process. While that might not be a matter that exercises the minds of people outside this House, people instinctively feel nothing is happening, which is what concerns me more than anything else.

There is not much to say on this legislation, which is basic, housekeeping legislation. We discussed the original legislation only at the beginning of last year and already we are amending it. We regularly see legislation introduced not just in the health area but also across other Departments to amend mistakes made in primary legislation that had been passed in the previous two to three years. This is in part because the Government tries to ram legislation through the Oireachtas. There have been long debates on how we will reorganise the House over the summer. We need to be very careful when we see the problems with such small, almost insignificant legislation. I hate to think what the result would be if this were to happen with some of the major issues that will need to be addressed.

I hope we will see an independent inspector for nursing homes. I also hope the Government will address the serious issue of illegal nursing home charges, which will cost the taxpayer €1 billion. I have not heard much from the Department of Health and Children as to how that matter will be resolved in the next 12 months. We all know what happens when the Government drags its heels on issues like this. When the law of the land is broken, those affected go to the courts and we are left with significant legal bills to pay when the courts confirm the Government was wrong. Dragging heels on this issue will not make matters easier for anybody. This matter must be dealt with quickly.

This Bill has been introduced with great speed on the last sitting day of the Dáil before the recess. I hope that over the summer the Government will prepare the legislation that needs to be implemented, especially the Irish Medicines Board (Miscellaneous Provisions) Bill 2005, which the Government identified as a priority. We have approximately 36 to 48 trained paramedics in the country, yet that qualification is useless to them because they have no legal standing when it comes to administering drugs. Without enacting this legislation and as a further batch of 16 paramedics will complete training over the summer we will look like a laughing stock as far as reforms are concerned. It is very expensive to train these people. Simple legislation is required to allow them to carry out their duties as paramedics in the ambulance service.

The Government also needs to proceed with the medical practitioners Bill and to deal with good samaritan cover. Once paramedics start to administer drugs at the side of the road, when GPs and other health care workers turn up at accidents if these medications are available in the back of an ambulance, there will be an expectation that qualified and trained doctors and nurses will be able to use the drugs and equipment in ambulances. As I know from experience, many doctors can become deskilled over the years. Equally many doctors who are now qualified do not feel comfortable to act as trauma doctors on the side of a road or at a major accident. They may not be totally comfortable with using the medication and equipment in the back of an ambulance. We could well see more court cases in this regard in future.

This is the future the Government is creating for the Irish health care service. Legislation will always lag behind scientific changes and new processes in the health service. However, it would be a sad day for the House if we fall behind in backing up the so-called reforms and changes to the health service. Rather than wait to end up in the courts in the future because of mistakes that are likely, let us pre-empt what will happen and introduce the legislation in the next 12 months. I hope the Minister of State will bring this message to the Tánaiste and Minister for Health and Children and highlight the importance of what we are failing to do in this House.

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