Liam Twomey (Wexford, Fine Gael)

I have searched high and low across County Wexford and still cannot find them. There should be at least three in the county by now.

The Government gave a commitment to provide 800 long-term beds in the public sector this year. However, in a response to a parliamentary question about the programme for additional publicly-owned extended care beds, the Minister said an additional 446 beds would be provided this year. The other 400 will be provided in 2008. This is simply spin that she is doing something for the health service. The reality is different. For that reason it is difficult to know whether the €400 million provided for care of the elderly services is actually spent there.

The former director of primary care services in the HSE once attended a meeting of the health committee. When he was questioned about the number of home help hours being provided by the HSE, he said he did not know the number, as the HSE had no way of measuring the total number. We do not know if the services the Minister says are being provided for care of the elderly in the community are being delivered by the HSE.

It is not the only area of the health service where everything appears to be disjointed and out of kilter. It is possible the nurses will go on strike, although the Minister and the Taoiseach do not have much to say about it. The Minister places a great deal of emphasis on what the general practitioner and primary care can do in the community.

From next year no doctors will be trained in Cork because all those who train young doctors there have pulled out owing to the protracted negotiations with the HSE. A successful training system for young doctors has collapsed and is imploding. Significant numbers of qualifying physiotherapists are not being employed by the HSE, even though they are badly needed. Occupational therapists play a significant and important role in defining services for those with disabilities and the elderly who need facilities to make it possible for them to live in their own home. The Minister constantly refers to people living in their own home and the care of people with disabilities, yet one of the key factors in the delivery of such services — occupational therapists — are not available. It is unacceptable that the waiting time to see an occupational therapist is six months.

The sham report on radiotherapy services produced in July 2005 shows that the Minister has contempt for those who require radiotherapy. It is also a sign of arrogance and a pointer to the way the HSE works. I stated I have my own concerns about political accountability and political interference in the HSE and stated I would like to see the HSE reined in. The report demonstrates what I mean by the need to rein it in. In the days of the former health boards there was political interference but also political responsibility to some degree. Now we are left with the political interference and no political responsibility. The Minister constantly tells us that these are issues for the HSE to deal with but there is evidence of significant political interference in the health service, a matter about which we will question Professor Drumm in time to come. The response of the board of the HSE to this allegation is a clear indication of how it occurs.

Fine Gael will improve access to primary care for both young and old. We will provide a doctor-only medical card for every child under the age of five years. Both my wife and I are general practitioners but we have often had to weigh up whether to give one of our children an antibiotic. We have three young children under the age of six years. The financial element in a parent's decision on whether his or her young child requires a medical opinion needs to be taken away. This is the reason for the Fine Gael proposal. It proposes to provide health insurance for every child under the age of 16 as a way of making all children equal, rather than simply paying lip service by means of a referendum on children's rights as proposed by the Government.

I will allow other colleagues to speak on the other Fine Gael policy proposals. Reform is about matching resources such as manpower, beds, theatre space and occupational therapy services and dealing with industrial relations issues. It is about time the Government showed real leadership in delivering services for the people.

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