Jan O'Sullivan (Limerick East, Labour)

They are not getting it, through no fault of the people who work in those services. It is the fault of the entire structure that has not been improved since the Tánaiste became Minister. The necessary sense of urgency is lacking in dealing with this problem.

I fear the problem will only get worse in the coming months. I believe the information coming from the Irish Nurses Organisation, INO. These people work in hospitals and I consider the organisation's figures to be perfectly accurate in reflecting what is going on in them.

I am concerned at the confusion that exists regarding the implementation of the Hanly report in terms of relationships between hospitals. We do not know for sure if the Hanly report is being implemented. In my region, both Ennis and Nenagh hospitals are still unsure of the future of their accident and emergency services. In Limerick, which I represent, we are not sure about how the Midwest Regional Hospital will be affected or if it has the capacity to deal with patients who may come in from other parts of the region.

We are doing nothing to help people to move out of hospital, who are badly described as "bed-blockers". This term should not be used to describe people who need long-stay care or support in the community. No co-ordination exists on the matter. I hear regularly about people who could leave hospital if they could get, for example, a disabled person's grant, home help and other supports in the community but it is very difficult to get these co-ordinated quickly enough for a person to move out of an acute hospital bed. That must be organised on a policy basis. It is the responsibility of the Minister for Health and Children to ensure there is a nationally co-ordinated policy across Departments to ensure the necessary supports are available in the community. That is not just the responsibility of the Health Service Executive.

In the time remaining I wish to address an issue pertaining to the mid-west of which the Minister of State, Deputy Tim O'Malley, will be well aware: the provision of radiotherapy services. In the Government amendment there is a reference to the development of a national radiotherapy network to provide essential cancer services for patients in each region. People in the mid-west have raised funds themselves for radiotherapy services. They want to know if the Government will provide money for public patients to be treated on an equal basis in the radiotherapy unit that is about to open in the Midwest Regional Hospital. There is still a lack of clarity on the issue. We want a clear answer from the Minister. The Midwest Hospital trust fund should not be used to pay for provision for public patients in need of radiotherapy services in the region. That is the responsibility of Government.

There is also confusion as to whether we are still a finite region. We are supposed to be linked to Galway for radiotherapy services and we are linked to Cork for BreastCheck. We are awaiting a number of other specialties. People are not sure if the Midwest Regional Hospital is to be an adjunct of Galway. What is the situation? It is most confusing at present.

Child psychiatry inpatient beds have not been provided in the mid-west. There has also been a lack of provision in the areas of neurology and mental health care in accident and emergency units, which my colleague, Deputy Neville, has raised many times and of which the Minister of State, Deputy Tim O'Malley, is well aware. There is a litany of issues that are of concern to the public and to us as public representatives but there is no evidence that the political will exists to address these issues in a positive way.

I spoke to a relative of somebody who took ill suddenly while on holidays in another EU country. The instant care available and teams that could speak to the family and provide a full service were such a contrast to what we have here. The public had confidence that the Tánaiste would deliver. She has now had stewardship of the health system for a year and the public has been hugely disappointed. I hope that things will not get worse but I very much fear they will in the next few months.

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