Liz McManus (Wicklow, Labour)

I thank Deputy O'Sullivan for sharing time with me. It is welcome that there is additional money this year to fund public services. The taxpayers are ensuring that we are in a position to provide for increases in the Estimates. Frankly, the big concern among many people is how the money is spent and how it is wasted due to incompetence. There is a litany of incompetence on the part of the Department of Health and Children and, indeed, the Minister for Health and Children in recent times. Whether it is nursing home charges or PPARS there are significant milestones of incompetence and waste that are disturbing.

Given that it is taxpayers who pay the bills for the health service, the general expectation would be that their needs should be met. However, these Estimates simply reinforce the status quo and, indeed, will deepen the two tier nature of the health service rather than alleviate it. That deliberate, ideological imprint has been put on the Estimates by the Minister for Health and Children. The Labour Party opposes this and will highlight it in every way possible. The 5% increase in the allocation for medical cards, for example, shows that the Government has no interest in providing for people on low and modest incomes who cannot afford to go to the family doctor. They do not have a medical card because they are just above the income thresholds and are being crucified for the cost of medication when they get a prescription. That is one of the great scandals with regard to Government promises and the actual outcome of those promises.

The other issue that must be highlighted relates to the Minister's agenda of privatisation. This idea came, presumably, from her political advisers. It will certainly increase the number of private beds but will not necessarily increase the number of public beds. The policy is costly, wasteful and will deepen the divide in the health service. Frankly, nobody outside the Progressive Democrats' coterie of ideologues sees the point of the venture other than those who will make a great deal of money from it.

It is estimated that 2,200 beds are required in the acute hospital sector. We will not get them. In fact, the capital fund has been cut this year. On radio last Saturday I had an argument about the matter with the Minister for Education and Science, Deputy Hanafin, but it is clear that I am making a valid point. We need to see an expansion of the capital programme but instead we are seeing an unnecessary and undesirable shift towards private hospitals which will not deliver the results the Minister for Health and Children, Deputy Harney, claims for them.

It is worth noting that the accident and emergency task force will now produce a report which will include a reference to the issue of acute beds, even though that was not the original intention. Acute bed capacity is a significant issue among a population which is expanding and growing older. It is time for action by the Government, yet the only clear signal coming from the health Estimates is that we will not have the additional capacity we need.

A curious series of allocations has been made to the HSE area boards which are essentially the former health boards in a new guise. An explanation is needed regarding why certain HSE areas receive so much more than others. For example, the mid-western area will receive a 3% increase, whereas the north east will receive12%. It is not good enough to allow such disparities, given that a figure of 3% represents a cut in real terms once one allows for medical inflation. We need to know why there are disparities. In view of the fact that the north east has experienced a number of problems, is it the case that more aid is given to such areas, whereas more efficient areas find their budgets cut?

It is regrettable that the opportunity was not taken to address people's needs rather than exacerbate the two-tier system. Unfortunately, we have a Minister who has a certain ideology, although the time when we can replace her is, one hopes, approaching.

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