Liam Twomey (Wexford, Fine Gael)

We will return for a dose of reality to what actually happens in constituencies across Ireland. Last night, I stated that the most regretful issue about the organisation of health services was that the Progressive Democrats is involved in privatising everything, from family doctor services to home help services and public hospital campuses, and that Fianna Fáil is either inept or complicit in the long-term damage being done to the delivery of health services.

Supersizing the present inefficient and uncompetitive public private system is of no benefit to either the patients or the taxpayer. A competitive private health care system is one that stands alone and is as independent as possible from the public health care system. The Government is making a fatal mistake by privatising public hospitals. I am surprised that civil servants in the Departments of Finance and Health and Children do not voice their concerns on this issue to members of the Government.

Waste and a failure to deliver is the continuing mantra of the Government and the Estimates bear this out. Failure to spend €50 million of capital projects funding last year is amazing given the number of TDs awaiting extensions to local hospitals and funding from central Government for community care projects. It is amazing that €50 million, or 10% of the capital budget, went back to the Department this year.

I would like departmental officials to explain a line in page 83 of the Estimates, which states, "The year-on-year increase in gross current health spending is 9% when account is taken of once-off monies provided in 2005, mainly related to the establishment of the Health Service Executive as a Vote". If we examine this figure, it is quite clear the increase in the health budget was 7%. If the HSE was not established in 2005, we are told it would have been 9%.

Does this mean it cost approximately €200 million to establish the HSE during 2005? That sounds like a fantastic sum of money for the establishment of the HSE, particularly when one considers the fees paid to consultants on PPARS and other computer systems. At least that €50 million was spread over a couple of years. If it is true, I would like the Department to clarify that figure. Perhaps I am reading the report incorrectly.

It is clear from the Estimates that the Government is big on rhetoric but small on delivery, particularly when it comes to care of the elderly, mental health issues and cancer patients. The debate held during the past 12 months on the stress and pain to elderly patients and their families caused by the distressing revelations about nursing home abuses seems to have been missed by the Government in the Estimates.

The Taoiseach promised that a social services inspectorate would be a priority in 2005. He now tells us it will be a priority in 2006, but I have my doubts. The same empty promises were made with regard to BreastCheck and they have also been exposed in the Estimates. These two services, with the Mental Health Commission and 16 other statutory bodies, are expected to deliver the promises made by the Government with an increase of only €3 million in their budgets. If that is achieved we will not have seen such a feat since the days of the loaves and fishes.

It is impossible to deliver BreastCheck, Mental Health Commission work, the social services inspectorate, with all that needs to be done, and the other 16 statutory bodies with only €3 million extra in the budget. I would like that explained more clearly. Perhaps it will come on budget day. The Minister for Justice, Equality and Law Reform may think he is a messiah but the Tánaiste, Deputy Harney, certainly is not. She is a mere mortal and it sounds ridiculous that she will deliver those Estimates on that much funding.

One aspect of the health Estimates I find strange and which shows that the privatisation agenda in Government policy is taking over our health services completely is the massive increase in funding to the National Treatment Purchase Fund. This contains a significant anomaly and I am surprised Fianna Fáil TDs, who proclaim to be socialist minded or equality minded, are going along with this stunt. The National Treatment Purchase Fund has been exposed as a bit of a fraud. The Minister of State should examine the figures. We would not consider paying any other public servants on the double in the same way as we pay consultants under the National Treatment Purchase Fund. It was exposed recently by the Comptroller and Auditor General that consultants are paid twice to do half the work on that fund. Half of the work done so far for the fund has been done in public hospitals. In one third of the cases, the work on public patients was carried out in the same hospital where that patient is on the waiting list for an operation. That is a scandalous way to use taxpayers' money. The Government should be exposed on that issue. It is ridiculous.

When we discussed this issue a few months ago, I made the following comparison: if GPs told the Minister for Health and Children that they were too busy to see their medical card patients, and the Minister came up with a scheme to allow doctors in private practice to see those medical card patients for a fee, and a review of the scheme three years later found that medical card doctors who were previously too busy to see those patients now saw half of them, there would be uproar about the waste of taxpayer's money in allowing such a system to develop. The Progressive Democrats, particularly the Tánaiste, Deputy Harney, holds this up as the great example of how we should run our health services when it is the most ridiculous public private partnership I have ever seen.

The Government's attempts to put private hospitals on the grounds of public hospitals gives us an idea of the road it is going down. It is supersizing the same nonsensical and uncompetitive private medicine and tagging it on to an inefficient public health system. We are going down the road to ruin on this issue.

The Estimates do not tell us much more, other than that there is no great commitment to health services in this year's budget. We are returning to the days of 2001 when the then Minister for Finance, Mr. Charlie McCreevy, stated that funding is for the delivery of the same level of services as the previous year. All these Estimates show is the same level of delivery next year as we saw for the past four or five years.

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