Liam Twomey (Wexford, Fine Gael)

It is sometimes depressing to stand on this side of the House and listen to the Government justify what it has not done. In some respects, it is like watching the Government get away with murder. Some of what has been said tonight reinforces that point.

In the course of the Minister's speech, she tried to claim success for a gross failure. She tried to say that her announcement of the appointment of the first board of the national cancer screening service was an achievement. The board will investigate the development of cervical cancer screening and examine whether to extend BreastCheck nationwide. It is a gross failure in a Third World country, never mind a country like Ireland. For the past 30 years, one could cross the Border and avail of cervical cancer screening services.

Breast screening has been in place there since 1993. The Minister, while claiming success from failure, said that she has established a board today to look into the development of this policy. It is similar to the HSE announcement that accident and emergency statistics have improved slightly since last year. This time last year the crisis in accident and emergency was a national emergency. Again, however, the HSE and the Minister claim success from failure in their treatment of patients in the health care system.

In the disgusting and disastrous case of Rosie from Kilkenny, a lady who had a colonoscopy delayed for seven months and was then diagnosed with cancer, she effectively became another victim of the health service, having been given a death sentence as a result of her bowel cancer. The Minister and the Minister of State's response is that it is regrettable. It is more than regrettable; what they have done to patients is despicable.

The next line in the Minister's speech showed the incompetence and lack of regard for what is happening. She stated that she had been assured by the Health Service Executive that a patient referred to St. Luke's Hospital for endoscopy and considered urgent will be given an immediate appointment and seen within one to two weeks. What is urgent? As far as I am concerned, every patient I send for a significant procedure is urgent. Will the Minister tell me how to decide when a patient is urgent and when he or she is routine? That is nonsense. We cannot define "urgent". We should see every patient in a reasonable timeframe so this sort of nonsense does not happen.

If the Minister goes to the trouble of looking at these transcripts, I would like to point out that the lady in question was not looking for an endoscopy; she was looking for a colonoscopy. The Minister does not even know what the patient was supposed to get — it was a colonoscopy. Perhaps the Minister might explain to me tomorrow night when she replies when a colonoscopy is not urgent. We could then make sense of the fact that patients all over the country are having their colonoscopies delayed by up to six months.

I will explain to the Minister of State what a colonoscopy involves. If a patient comes to me complaining of weight loss and bleeding from the back passage, it could be piles or it could be a bowel tumour. I cannot tell if the tumour is significantly high up the bowel — obviously, I cannot see that far. That is why we carry out colonoscopies. Can the Minister tell me when it is not urgent when a patient is bleeding from his or her back passage? Can she tell me when I can say to the patient that he or she can wait seven months? I cannot do that and I have been practising medicine for 20 years, but perhaps the Minister has a better idea of these things than me.

The Minister stated that real progress is being made in the implementation of the national plan for radiation oncology. Is that the radiation oncology plan the Minister, Deputy Martin, published or the plan the Minister performed a U-turn on in July 2005? Neither of them is going very far. The Minister, Deputy Martin's plan is gone, after we waited four years for it, while the Minister's plan turned out to be a sham. There was no policy. The HSE came out and stated it could not implement it. The board of the HSE, demonstrating the political interference involved, stated that management was wrong. It was interesting that the National Finance Development Agency was discussed today because that agency came out and stated that the management was right — the plan was a sham. The Government in its arrogance, however, stands over it. It does not care and says it does not matter. It is just another person in the litany of patients who are dying after ten years of Fianna Fáil-Progressive Democrats Government. This is the best it can do.

The Minister mentioned that four leading international experts have been appointed to validate the population needs assessment, technical specifications, process mapping and other outputs. Four international experts were not appointed to look into the decision to choose the Mater Hospital for the national children's hospital but that decision will stand for 50 years and cost €500 million. That is not just disjointed Government but total incompetence and that is how this Administration works.

I have published two policy papers since becoming Fine Gael spokesperson on health. The first dealt with primary care screening to cover every area. It covered blood pressure, because for every person diagnosed with a blood pressure problem, another person is missed. It covered diabetes, where the same is true. It covered cholesterol, which has a huge impact on heart disease, and it covered bowel cancer, cervical cancer and breast cancer. It can be done without establishing another group or commission but the Government does not want to do it. It comes out with soundbites instead.

Along with the Labour Party, we announced a patient safety authority. This policy will not set the world on fire or generate headlines but the consequences of not having such an authority can be seen in the headlines every day — MRSA, Leas Cross and Rosie in Kilkenny, just one of 40,000 people who stepped forward to say that because the Government is so incompetent, she will die. The Government just sits there, however, as smug as can be, saying we can wait another year or even until 2011 because it will not do anything in the meantime. The Government is letting patients die, even before we try to address hospital hygiene.

I am sick to death of smug Ministers, Deputies Martin, Roche and Cullen, saying on television that the Opposition has no policies. The Government has no policies. The Minister's speech referred to the implementation of the national cancer strategy in 1997. That strategy was published in 1996 by the rainbow Government. Patients are being treated according to a strategy the last Government drew up. It is amazing the Government acknowledges that because its national cancer strategy does not have any implementation plan. When it comes to patient safety, the Government ta lks about HIQA. Already I can see backbenchers getting shaky about it because even they know, although they do not put too much time into the area, that it cannot work and will fall apart.

The Minister acknowledged that the patient safety authority announced by Fine Gael and the Labour Party was far superior because she set up a commission to look into the plan, although it was not established to implement it. That shows how bloody useless the Government is when it comes to looking after patients.

There is even more to it. Look how screening is working. What is stopping the Government from making BreastCheck available in the west of Ireland? Does it have a psychological barrier at the Shannon? BreastCheck should be national by now, as should cervical cancer screening. The Government talks rubbish that it will send tests to the United States and try to reduce times to within two weeks if cases are urgent. When is a smear not urgent? The Government is great at talking but does not know what it is talking about. Britain screens its entire population and can have results returned within weeks.

On a programme about endoscopies, which the Minister should not confuse with colonoscopies, it was stated that the system would try to reduce the waiting time for patients who needed endoscopies from six to four weeks, not six to four months. The Government, however, thinks it is doing a great job if an urgent endoscopy can be carried out in two weeks when it does not even know what is an urgent endoscopy. The only colonoscopy I would consider urgent is when the patient is like that poor individual Mr. P. J. Walsh, who was bleeding out of his mouth and had a burst duodenal ulcer. He could not wait two weeks, he could not even wait two hours. That is so urgent the operation is needed immediately.

That is how a health service should work. It should not work like this, with the spoofing the Minister and Minister of State have come out with tonight. They are pure wafflers and spoofers who are murdering patients because of their incompetence.

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