Mary Harney (Dublin Mid West, Progressive Democrats)

The HSE is not an end in itself. It is merely an enabler of change, reform, accountability and of the creation of a consistent and equitable health service for all our patients. We are only at the beginning of the journey but the signs are encouraging.

I have been asked by the Leader of the Opposition to issue a political directive to the HSE, under section 10 of the Health Act, regarding surgical procedures at Monaghan General Hospital. Politics have bedevilled hospitals in this country for many years — party politics, medical politics and office politics. The only sure thing is that when politics comes first, patients come last. There will be no political directives from me interfering with the management of hospitals. I will not undermine the mandate given by the Oireachtas to the HSE to professionally run, in the interests of patient safety and care in each region, our hospital system.

Accident and emergency has been a major pressure point for some time in the health service. Each day, on average, accident and emergency departments throughout the country see 3,400 patients. Thankfully, the vast majority of these patients are seen speedily and do not have to wait overnight on trolleys for admission to a hospital bed. There are many diverse factors that lead to overcrowding in accident and emergency units. There is no single solution to the difficulties. We need a wide range of initiatives to put right the problems which have been in accident and emergency departments for some time, which is what we are doing. We have, for example, gone to tender in the north side of Dublin for out-of-hours GP services, the first time this has happened. It will make a major impact on the accident and emergency departments in the Mater and Beaumont hospitals and, to a lesser extent, at Blanchardstown hospital. We have also bought long-term and step-down beds so that those who can be discharged from the acute hospital system can move to a more appropriate setting. A national hygiene audit, the first ever, has been completed and the results will be published. We will not sweep the results under the carpet because we need to know what the situation is in our hospitals if we are to achieve higher standards. We need base data. We have opened new accident and emergency units at Blanchardstown, Naas, Roscommon and Cork and shortly a new 25-bed unit will be open at the Mater Hospital in Dublin.

The past year has been one of reform, breaking barriers to innovation and clearing away some of the ossified legacies of the past. It has been a once in a generation change in health management and accountability. It has been a year of major innovation in medical card benefits. It has been a year when the focus has been on the difficulties in accident and emergency. It has been a year when we sorted out the 29 year legal mess surrounding long-term charges, when we delivered a national policy on radiotherapy, when we delivered multi-annual funding for disability and when we have had new treatments, new beds and new investments. It has been an exciting year, but no one year can sort out our health services. What the one year can do is set us on the right road. That is the road we have taken and that will deliver results. It is the road that will ensure that Ireland has a world class health system.

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