Liz McManus (Wicklow, Labour)

It would be good if the Minister was woman enough — being man enough would not be as good.

I welcome this debate. This is important legislation but it is also deeply disappointing. I wish to set the legislation in context. Thousands of patients are cared for properly and well each year in our health service but too many are not and they must be the focus of our attention today.

The story of a young mother called Rosie, as highlighted by Joe Duffy's "Liveline" radio show, is a stark and terrible lesson about the Government's failure to protect patients and provide them with quality care when they need it. Her life has been tragically foreshortened and her family traumatised to a heartbreaking degree, but the truth is she is not alone in her suffering.

In preparing for this speech today I looked at my own caseload, as one Deputy out of a total of 166. I suspect when it comes to complaints about the heath service none of us does anything more than touch the edges of the complaints that exist. I wish to give some examples of the cases I am dealing with in County Wicklow. A man in his early 60s spent this Christmas worrying about the five month delay he was experiencing as a public patient waiting for open heart surgery. He came to me as his local Deputy and, eventually, only because of the kindness of a secretary in a private hospital he has just been operated on following months of anxiety.

Today I was trying to help Pat, a patient with bone cancer. I am sorry to say it was without success. His pain is ferocious. He needs to be in St. Luke's Hospital. Yesterday he waited all day for the ambulance to take him but it never came. A nurse waited with him all day but to no avail. His admission to St. Luke's has been delayed by a further week. His suffering is now prolonged beyond endurance.

A few days ago I spoke to a mother whose beautiful 18 year old daughter died at home while they waited an hour for an ambulance. In their case the ambulance came but it was too late. Another lady called Ann has been waiting since 2004 for a bedroom for her disabled son under the disabled person's grant scheme. During the three year wait her own health has deteriorated to the point where she cannot manage the stairs. Her chances of getting a downstairs bedroom for herself are now being thwarted by the same county council that has already kept her waiting three years for a downstairs bedroom for her seriously disabled son.

In 2006 the Minister for Health and Children announced with great fanfare a repayment scheme to repay older people in residential care who were robbed by the State. We all welcomed that scheme. As is her wont, the Minister opted for the private sector to administer the scheme. She promised it would be faster, more efficient and more responsive, but the experience has not lived up to the promise. Last week I was honoured to present the President's cheque to a woman in Bray who had reached the great age of 100. Since she goes three days a week to play the slot machines on Bray seafront she can enjoy spending the money. However, this lady has been trying to extract her entitlement to repayment from KPMG and McCann Fitzgerald, the scheme administrators, since September 2006. We are now approaching February 2007. Not only can this lady not get the money she is owed, she cannot get any information about the payment date or why it is being delayed. This lady is in her 101st year. Time is not on her side. To whom can she turn for redress? Clearly this Bill that promised so much does not provide her with the justice she readily deserves. Yet many times when similar issues have been raised the establishment of HIQA had been proffered as a safeguard for patient safety and protection. These patients and others are being told to wait 18 months for a commission on patient safety to produce yet another report, in a health service that is weighed down with reports that have not been implemented. What will the commission do? It will tell us what we know already. It is not as if we do not know the problems.

The Bill to establish HIQA on a statutory footing is being debated. When I came to look at the Bill I posed a very simple question — a simple yardstick — as to its merits. Will it protect Rosie, Jerry, Ann or Pat into the future? The answer, regrettably, is no. This Bill does not provide the comprehensive and wide-ranging protection that patients need and deserve. In fact the Minister for Health and Children has implicitly acknowledged her failure on patient safety in establishing this new commission. She launched it last week ahead of the Bill being debated. If this Bill were up to the task it promised, there would be no need for a commission. The Minister's failure is defined by the gross deficiencies in this legislation and I regret that. I appreciate she has a hard job of work to do but this was legislation we knew was coming. The inspectorate in social services was integrated into it even though it meant a delay. This was the Bill that could have delivered on patient safety and yet again we are facing a failure and I regret that very much.

The Bill is essentially in two parts. It will establish a new independent inspection system for all nursing homes and care institutions and provide for a nursing home to be struck off the register if it fails to meet new care standards. It proposes a new agency, separate from the Health Service Executive, to independently inspect all public and private nursing homes and residential facilities. That is good news and I do not want to be churlish about this. It is a long time coming but it is being provided for.

More than 18 months have passed since the "Prime Time Investigates" exposé into Leas Cross nursing home. The controversy that arose out of that exposé led to legislation being demanded by an outraged public. The most disturbing conclusion in regard to the Leas Cross exposé was that it was clear there was systemic failure in the system rather than it being some kind of maverick institution that was an isolated case. In 2006 we witnessed some disturbing cases of neglect and malpractice in our health service and the exposure of poor practice. It was a year that saw reports into major scandals in health care provision — the Our Lady of Lourdes Hospital inquiry, Leas Cross and the death of Pat Joe Walsh.

February 2006 was dominated by the publication of Judge Maureen Harding Clark's report into obstetrician, Mr. Michael Neary. The report noted that Mr. Neary, or Dr. Neary as he was then, had carried out 129 peripartum hysterectomies at Our Lady of Lourdes Hospital in Drogheda between 1974 and 1998. Most obstetricians carry out less than ten of these procedures in their entire career. The report described this as "truly shocking" and highlighted the fact that no one shouted stop. A brave midwife and her companion did finally shout stop. Yet to this day that midwife is unwilling to identify herself. Instead of receiving accolades she chooses anonymity. What does that tell us?

I expected the Minister for Health and Children would provide the good robust protection of whistleblowers legislation as the Labour Party has done. We prepared the legislation and published it but the Government equivocated and we are still waiting for that provision to be made. There is praise for the unknown midwife but little or nothing has been done to ensure that others in the health service will feel brave and secure enough to come forward when malpractice or neglect occurs.

In September 2006 we saw the publication of the report into the death of Pat Joe Walsh. This man bled to death in October 2005 because he could not be transferred to another hospital for emergency surgery. The report describes some of the events on the morning he died as "surprising and barely credible". In November 2006 the report on Leas Cross was finally published. It was highly critical of the standards of care there and also criticised the role of the HSE and former Eastern Regional Health Authority in regard to the running of the home.

All of these reports — Our Lady of Lourdes Hospital inquiry report, the report on the death of Mr. Pat Joe Walsh, the report on the death of Mr. Peter McKenna, of the death of Roisin Ruddle and the Leas Cross report — are only some of the reports that examine the institutional abuse of elderly, frail people, the surgical mutilation of young women and the death of a middle-aged man who bled to death. These reports were about individuals who sought care from the health service and who suffered deeply as a result. There are others such as the patient who contracted MRSA and was not told and the family only discovered the fact when it appeared on the death certificate, the child with a broken arm left for 20 hours without water, and an older man left undiagnosed and in extreme discomfort and covered in his own faeces while in hospital. The complaints range from dirt in the toilets to the death of a child through medical misadventure. Data collected by the State Claims Agency show that 1,000 adverse incidents involving patient care occur in Irish hospitals every week. It is estimated that this figure is only 30% or 40% of the real figure.

The intended role of HIQA was to be the guardian angel of patients. When the Government set up the Health Service Executive, from day one the commitment and the understanding was that the balance would be provided by HIQA which would be the watchdog, the guardian angel, the body to protect patients. However, that never happened. The Health Service Executive was launched by a Minister for Health and Children who refused to prepare and plan for it properly. We are suffering all the problems as a result of that lack of foresight in planning. It was launched and allowed go free and the important balance of HIQA was never provided to protect patients. That has got to be seen as a grave political error and a failing when it comes to ensuring proper health care. Even now the Bill is not doing the business when it comes to providing the necessary powers to regulate services across the board, including the hospitals. The Minister said half the people die in hospital. She is absolutely right.

See this speech in context