Finian McGrath (Dublin North Central, Independent)

I welcome the opportunity to speak on the Health Bill 2006.

This important debate allows us all to make constructive proposals on the running of the health service. Before going into the detail of the legislation, if we wish to sort out the health service once and for all, we must invest. We also need reform and, above all, more beds in hospitals. Anyone who proposes the opposite of such a strategy of investment and reform is not being honest with the electorate. We have the money and resources to look after our elderly, disabled and sick citizens, and it is up to the Government to act on that wish and use resources to assist them. That must be at the core of this debate. Let us end the waffle and invest in change and reform. We must look after the sick and elderly and, above all, the disabled.

It saddens me to hear hospital representatives and politicians fighting over a children's hospital. It is time to end the squabbling and get on with the new hospital. I support the independent and sensible proposal to locate the new children's hospital on the Mater site. The research has been conducted, and I strongly support it. When one considers the details and facts, one sees the real situation. The McKinsey report studied international best practice in tertiary and secondary hospital-based paediatric services and its strategic implications for Ireland. McKinsey was not commissioned to recommend a site for the new hospital, and therefore paediatricians consulted during its preparation were not asked for their views on any site. Those are the facts.

The McKinsey report published in February 2006 stated that Ireland, because of its population size, could support only one paediatric hospital. It was highlighted that the greater the volume of patients and procedures, the better the outcomes would be. Examples were given of where fragmented services had been brought together, with improved survival rates as a result. In other words, that was good practice and in children's interests.

To ensure a critical mass of patients and activity, McKinsey recommended that the hospital be located close to an adult teaching hospital, provide secondary paediatric services for greater Dublin, and be part of a national and city-wide integrated service. McKinsey said the adult teaching hospital should have an appropriate level of specialties. Of the 17 paediatric services across the world that McKinsey examined, 15 were co-located with an adult teaching hospital. Three existing children's hospitals accepted the findings of the McKinsey report. That is the reality, and the Minister for Health and Children and those directly involved should get on and build a hospital on the Mater Hospital site in the interests of sick children.

When one considers the legislation before us, one sees that the Bill provides for the establishment of a Health Information and Quality Authority and an office of the chief inspector of social services, also establishing a registration and inspection system for residential services for children in need of care and protection, people with disabilities, and older people. The core principles therein are extremely positive, and we must ensure that those bodies that implement them have teeth. We have a responsibility to inspect providers and ensure that children in care, those with disabilities, and older people receive a quality service. This debate is about service standards and the quality of service, and the legislation attempts to do something about that.

It always amazes me when I see staff from the HSE go into a public house, in a bike shed behind which one or two people are smoking, and close it down, since it does not comply with regulations. At the same time elderly people are on trolleys or in institutions, and the inspectorate and HSE are nowhere to be seen. Why is swift action not taken regarding such people? Our elderly citizens must be supported and looked after.

Section 6 provides for the establishment of the authority to perform the functions assigned to it under the Bill as a body corporate that may sue and be sued in its corporate name and acquire, hold and dispose of land or an interest in land or any other property. It also provides for the authority to have a corporate seal. Section 7 sets out the authority's functions, providing that it set standards on safety and quality regarding services provided by the HSE and in accordance with the Health Acts, except for services under the Mental Health Acts 1945 to 2001, which are the responsibility of the Mental Health Commission, the Child Care Acts 1991 to 2001, and the Children Act 2001.

We are talking about and insisting on standards for people. It is unacceptable that a constituent should have been waiting in Beaumont Hospital for the last six months for a public nursing home place. That man, in his 80s, is waiting and there is no movement on the issue. I raise those questions because of their importance. As the Minister of State, Deputy Tim O'Malley, is in the Chamber, I also highlight the importance of our developing services for psychiatric patients, particularly mental health services. We must do something in that regard and improve services. Today 60 psychiatrists said that resources and services were not being put in place. The Minister has challenged them on that, but they should get on with the job and act. The money and resources are there, and those people need our support.

Since we are on health, I was astounded and outraged to view a recent communication from the Health Service Executive to the Irish Pharmaceutical Union, the IPU, stating it could not negotiate fees or remuneration with the union for pharmacists operating State schemes, as that would contravene the terms of the Competition Act 2002 regarding price-fixing. That came from the same HSE that quite literally fixed prices with drug-manufacturers last year. I say that regarding the pharmacy sector, about which the Minister of State will know a great deal, given his background.

Pharmacies are a vibrant part of the country's primary care infrastructure. They have always been unique in their ability to deliver on their brief on time and on budget, with scarcely a whisper of patient discontent. They provide an accessible service over long hours and with excellent value for money for the State, often being at risk of robbery and physical violence by virtue of the type of product stocked. Other sectors are beset by constant and seemingly insoluble problems: waiting lists, accident and emergency departments, nursing home scandals, overspends on computers that do not work, MRSA and so on. All the while the professional, responsible management of medicine and drugs in the community has continued without fuss, waiting lists, or public and private case distinctions.

Some 400,000 people visit Irish pharmacies every day. A recent survey found that 95% of people trusted and valued the advice and care of pharmacists, with 71% stating that they availed of pharmacy services every month. Pharmacies are an essential first port of call to keep people out of accident and emergency departments. I raise that to lend my strong support to the IPU in its simple and sensible demands, which are the way forward. Negotiations should commence between the IPU and the HSE on the payment of fair fees for the provision of dispensing services to 75% of subscription-holders in the country. Provisions must urgently be put in place to ensure the continuity of drug supplies during implementation of the drugs cost reduction measures to ensure patient welfare is maintained and that pharmacists are fairly compensated for the changes thrust upon them. Third, appropriate and realistic remuneration must be agreed as a matter of urgency for the continued operation of the methadone scheme to take account of the costs and risks associated with its operation by community pharmacists, whose work I commend. Many have taken risks in that regard. I raise those issues because they are part of any sensible health strategy. If a group of people within the health services are providing an excellent service we should support them.

Section 39 establishes the office of chief inspector of social services and outlines the remuneration, appointment and grounds for dismissal of the chief inspector. It is important that credible people with integrity, who will put care of the elderly at the top of the agenda, are involved in this office. We have many examples of quality public service and now we need such people in this section of the health services to ensure the elderly, disabled people and children are given maximum protection and professional care.

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