Liam Twomey (Wexford, Fine Gael)

As the Dáil will sit for just eight more weeks before the general election, it is important that the Opposition should continue to highlight its concerns about the health service, while outlining its solutions to such problems. The Government's failure to reform the health service, after ten years in office, has landed us with an awful legacy. As I said last week, the Government has no clear policies for the future of the health service. It is clear that the policies published by the Government in the past have not been implemented to any significant degree. The Government's amendment to the motion before the House demonstrates that the health service continues to be poorly structured, after ten years of this Fianna Fáil-Progressive Democrats Administration. The national review of acute hospital bed needs under way will identify the number of acute beds which will be needed up to 2020. That the review will tell us the number of beds we will require in 13 years' time is a demonstration of the Government's crazy attitude to the health service.

Another part of the amendment that deserves comment states: "regrets that some patients have their operations postponed when priority is necessarily given to emergency cases; recognises that postponements cause upset and inconvenience for patients and their families...". "Inconvenience" is not a word I would apply to Rosie. This postponement did not cause inconvenience but a delayed diagnosis of her cancer. As a result of the delayed diagnosis, she has more or less been handed a death sentence by the Government.

During the debate on Private Members' Business last week the Minister said the HSE had been instructed to provide an urgent colonoscopy within two weeks for those who require it. I asked the Minister to define what was meant by an "urgent colonoscopy". If a patient presents to me with signs and symptoms of what could possibly be bowel cancer, an urgent colonoscopy is required. A number of my patients had procedures cancelled and they were subsequently diagnosed with bowel cancer. They do not have the disease to the extent suffered by Rosie and received treatment within a certain timeframe but it had a significant effect on their quality of life because they required more aggressive treatment because of the significant delay in receiving it. I am a qualified doctor and do not send a patient for a colonoscopy unless I consider it urgent. Every person who needs a colonoscopy should be seen as urgently as possible. In Britain a great deal was made of the fact that in the NHS patients had to wait six weeks. In this country one would not even get on the waiting list for a colonoscopy in six weeks.

The amendment "notes the significant increase in intensive care and general bed capacity at St. James's Hospital". This gets around the comments by the Tánaiste about crises being taken down from a shelf. His insensitive remarks about the way patients are treated in St. James's Hospital shows an unbelievable arrogance. When commentators from the back benches try to spin their way out of this problem, they say there has been a 50% increase in the number of intensive care beds in St. James's Hospital. In actual numbers, one new intensive care bed has been provided in St. James's Hospital in every year for the last five. In a hospital which carries out such complex surgery one new intensive care bed per year can hardly be considered a record achievement by the Government. It is time to put real doctors in our hospitals, get rid of the spin doctors from the Government benches and deliver these services. It is a 50% increase on very little. St. James's Hospital should have a massive intensive care unit in view of the complex surgery carried out there.

There is also the Minister's co-location plan to provide new facilities on the campuses of public hospitals. It was interesting to hear on the news this evening that she intends to sign these contracts in May but that she will also insist that the consultants' contract is renegotiated in the next seven weeks. I am glad there is some reality in the Department. An investor would be mad to sign a contract for the new private hospitals without seeing what the new consultants' contract will offer. The success of these hospitals depends on a new private consultants' contract, and there is none.

Patient care is another issue, and the Minister has been extremely evasive when I have asked questions about it. If consultants are taken out of the public hospitals, patients will be exposed to the care of less senior doctors. The Minister will make the current situation worse. In the private hospital one will see the consultants going home at 5 p.m. and the patients there will be under the care of doctors who are not in training and are unsupervised. Both private and public patients, therefore, will get an extremely raw deal from what the Minister is offering.

The amendment asks us to support the Minister in negotiating the consultants' contract. This time last year I offered her my full support when she said she would introduce public-only contracts if the negotiations did not get under way quickly. At the time I asked her to put a timeframe on the negotiations and suggested that it be the end of March. Nothing was done. Why did the Minister do nothing throughout 2006 to push the consultants' contract talks forward? There are eight weeks of the Dáil session remaining. If there is any delay, we will be in the middle of an election campaign with no new consultants' contract. The Minister should be more honest about why this process fell apart.

The best way forward is for the Minister to chair the talks. At least then we would know whether the talks collapsed because of what the consultants or the Department and the HSE were doing. The consultants' contract talks of the last three years have been the most unbelievable nonsense and I am surprised the Minister allowed it to continue under her stewardship of the Department. I would not mind if it was the former Minister, Deputy Martin, given his failure to act in a number of other crises. The Taoiseach should have fired him or one of his Ministers of State for what happened with the illegal nursing home charges.

As a result of the Taoiseach blinking on that issue, political accountability in the Government has gone into freefall. One need only consider the issues that have arisen in the past 12 months. There was the failure to act in the Leas Cross crisis, for which we still do not know if anybody will bear responsibility. Tonight we saw on the "Six One News" that a lady who worked in the blood laboratory will become a scapegoat for the huge hepatitis C crisis. We have seen what happened in Leas Cross and to a number of patients in the nursing home sector during the Minister's term of office but nobody is taking responsibility for it. What will happen in that case? Will a junior clerk in some department in north County Dublin take the rap in five or six years? It is a shocking disgrace in respect of how the health service is being run.

What happened with BUPA and with regard to the loophole that will impact on the private patients of VHI? A total of 1.6 million customers of VHI will see their premiums go through the roof. Much of this is related to Government policy and the fact that the Minister is trying to build co-location hospitals and increasing charges for private beds. A former colleague of the Minister, Mr. Charlie McCreevy, is trying to impose sanctions from elsewhere in Europe. In addition, the usual health inflation issues will impact on premiums. What happened with regard to the BUPA loophole, of which the Minister was informed a year ago?

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