Liam Twomey (Wexford, Fine Gael)

Is Deputy Martin and the rest of the Government paying lip service to what is happening?

There is a need for robust management within the health service. People such as Dr. Ambrose McLoughlin and Dr. Finbar Lennon put their necks on the line to get this through. That same robust management does not exist right across the health care service. Management is still intimidated by consultants and other vested interests within the health services, and the Tánaiste knows this. I would like to see her being more proactive in discussing this, and not being wishy-washy about a new consultants' contract or arguing that new management systems will be introduced.

The Tánaiste knows there was a case in this country where a consultant was pushed out of a hospital as other consultants in the hospital were not happy with the amount of work he was doing. He was working too well and fast, eating into the private practice of other consultants. Through management, those other consultants were able to get the doctor pushed out of the hospital. They bullied and intimidated weak and pathetic management into protecting their interest. The Tánaiste is aware of this case and she has done nothing about it.

I could quote other cases where we have seen bad management, and where management has been intimidated into being at the beck and call of individuals, not for the best patient care but for their own interests. The Department of Health and Children and the Government has shown no concern about this. We will be pushing these issues on this side of the House. This report, like the Ferns Report and others which condemn Government policy and which have come out in the past few years, will merely fall to one side. The Government remains apathetic on the issues. We in the Opposition will not let that happen in this case, as this is far too important.

The Department of Health and Children has a disastrous record on legislation in the past eight years. There has been a poor amount of legislation emanating from the Department in that period. We should be more proactive with regard to employing consultants in the future, and what types of checks and balances are being introduced. We must support good consultants, as there is a significant number of good consultants working every day on behalf of patients. However, people can go bad in this system as there is nothing to hold people back. This needs to change dramatically.

The Tánaiste should propose a proper patient safety authority. This would not be a subsection of a subsection of HIQA or an expectation of the Medical Council or HSE complaints procedure. I would not like to rely on the HSE complaints procedure to sort me out if I was a man on the street with a problem with the health services. We in the Oireachtas, directly responsible to the whole country, have a disastrous flow of information coming to us from the HSE. I believe this to be deliberate.

The Freedom of Information Act, the HSE and many parts of the health services are being treated in a way that aims to stop the flow of information. The Government has been made less accountable to the people, and transparency has been knocked out of the system. It will come as no surprise to me if there are future cock-ups like this. Processes are being developed to cover the Government's inadequacies. The Tánaiste should face up to this truth.

I have asked a question on a number of occasions with regard to Comhairle na nOspidéal. It has been responsible for hiring consultants, but it is being subsumed into the HSE. There is no clear idea of what the body is doing and who is employing consultants. As it is run by consultants, who make decisions on other consultants and where jobs will be, the system behind it has been abused. It has been manipulated in a way to ensure favoured people get favoured jobs in certain hospitals. It is a fact of life which I am sure the Tánaiste knows about.

What has the Tánaiste done with regard to the reform of the HSE to ensure this does not happen in the future, or to prevent the ways and means of stopping it? Nothing has been done, and it is all lip service to the concerns we are all considering in the health care services. Action is not being taken.

Some of the recommendations relating to clinical audit, competence assurance and peer review were included in the Hanly report. That report was a bit of a mess, as it was again written by a small cohort with its own interest at heart. I pointed this out in the past, but the Tánaiste took no notice. All the issues surrounding the vital matters of competence assurance, peer review and moving forward to genuinely protecting patients have been in every Government strategy since it entered power. However, only lip service has been paid to them. The only time a hospital can put resources into these issues is when something goes wrong. That is no way to treat our health services, and it is absolutely disgraceful.

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