Bernard Durkan (Kildare North, Fine Gael)

I am glad of the opportunity to say a few words on this motion, which I support. I compliment Deputies Twomey and O'Dowd and the other speakers who contributed in its support; it is timely, useful and particularly important. When a report of this serious nature is compiled, I see no benefit to anyone in our sitting around and arguing legalities. There is no sense in our commissioning a report unless we ultimately do something positive about it. It is in everyone's interest for the report to be published without delay so all the information sought initially can be made available and the concerns expressed by those involved addressed.

I compliment those nursing homes that have run their show well in recent years, of which there are very many. The great majority do a tremendous job, provide great value for money, and look after patients in a very conscientious and caring way. Very often they do it for patients who require high-dependency nursing but lack the family that might provide such care. I compliment them on what they have done. Several nursing home proprietors have taken financial responsibility for extending the stay of certain people for whom it proved impossible to secure funding from the health service or whatever other source.

Having said that, there are others who have not adhered to the rules. There is a growing perception that facilities of this nature constitute an investment rather than the provision of a vital social, nursing and medical service. There is also a perception among HSE personnel that to draw attention to something of this kind is uncharitable, unworthy or unpatriotic. For some years a culture has been growing in the health service of refusing to listen to the obvious. We have all heard about haemophiliacs over the years, the reports, legal challenges and counter-challenges, and all the time and energy that went into their case.

Deputy O'Connor mentioned something a few moments ago regarding the old health boards and the job that they did for 30 years. They were supposed to do the job. They were abolished, having been used as scapegoats in the run-up to an election because the health services found themselves in difficulties. The Minister of the day decided to abolish the health boards to show the public his deep concern at the problem; we now know that it was no such thing. Let us remember that in the period from 1970 there was an inspectorate like the visiting committees in the health boards that did the job it was supposed to do for nothing. The difficulty was finding people to join visiting committees and give of their time. It was regarded as a great thing if one was in time for one's tea. That was an added bonus, as I well know, since I did it. With many people, there developed over the years a culture that one had to be nice to everyone. If one did that, it was thought that everything would be all right, but that is not true.

I remember sitting in this House with other Deputies many years ago and bringing the kind of carry-on current in some health board institutions to the Minister's attention. That was how the system was supposed to work; information was to percolate upwards through the system. It was only right and had to continue, although we were not popular for doing it. I do not wish to apportion unnecessary blame, except to say this. In the HSE today there is a new system, which I regard as closed and bureaucratic. It is not working in the way originally intended. I never believed it would work, but that is irrelevant. Abolishing the health boards was an abnegation of the democratic process, and their replacement is not yet visible.

I also wish to mention the great number of people who are dedicated health workers, in both public and private sectors. They do a tremendous job and display a vocational commitment that carries right through. That commitment will always ensure they do the job to the best of their ability and stand over what they do. They will be very quick to respond to any request for clarity at all times.

However, there is a growing culture throughout the system whereby such vocational devotion does not seem as visible as previously. There seems to be more reference to filling the job from 9 a.m. to 5 p.m. than to the completion of the task originally intended. One cannot walk off the job if a patient is in need of care. I am not saying that it happens, but it certainly would not have occurred previously owing to the degree of commitment.

As always, society is judged by how it treats the vulnerable who depend on it, whether the very young or the very old. That responsibility falls on us at all times, but particularly when the country is thought to be overflowing with money. It is supposed to be gushing out from everywhere. There is so much money that one Minister said that the Government did not need it any more. At this juncture, it is absolutely imperative that the highest standards, including regarding accountability, apply. There is no need to be at all embarrassed if someone asks whether the relevant standards are being applied, and no need for anyone to get upset or worried. There should be no reason; nor will there ever be.

There is no question that what happened in Leas Cross was the result of system failure. It is not the case that procedures were not in place or standards not applied. If the system had been operating as intended, the problems would have been spotted and a report compiled. There would have been no question of any legal interaction. There is no necessity for it. The challenges would be made on time. I do not know why we have got to this stage. The problem now is to reassert control to ensure the highest standards are applied at all times, not just some of the time. Remember, that applies throughout both the public and private sectors. incidentally, I recall many years ago there was a suggestion that standards in a hospital which was not the responsibility of the health board were not up to scratch. It was quite clearly pointed out that the same standards applied right across the system, inside and outside; there was no sense in having health Acts and laying down standards unless they were applicable across the board.

The importance of this debate should not be underestimated. In particular we should emphasise that we should learn from the lessons the debate highlights and initiate the inspectorate that has been promised. The Government amendment is appalling. It is the lamest excuse I have ever seen, put into print. This is no reflection on my colleague, the Minister of State, Deputy Seán Power. I am sure he agrees with me. However it was compiled or on what basis, I cannot believe it. It is barefaced, incredible. To produce that, one would need to have a neck like something else.

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