Damien English (Meath, Fine Gael)

Good. I do not blame a particular Government for the veil to which I refer, but we must admit it exists and sort it out. A Bill like this is a way to tackle that and to legislate to protect whistleblowers and those who want only to have everyday conversations never mind whistleblow on a serious matter. There is that feeling among staff in the health services that they cannot speak out and get involved. That is a pity because we need to hear everyone on these issues.

The people in the health service must realise their job is to help people provide a service, not to block access to a service or create issues to prevent a person from getting the help and service he or she needs which also happens. Often there are good staff in the wrong positions and bad staff as their bosses, and that needs to be sorted out. There is much expertise and many excellent staff among the health services who are not being used to their full ability. It is a shame and people will suffer as a result. There is a need for a root and branch review of everyone's position in the health service, which I thought would happen under the HSE but which has not happened. Instead, there have been more layers of bureaucracy and red tape. Eventually, maybe this will lead to a result. In some areas it has already, but in many cases it has not. I accept that such change takes time but we need to drive it much faster in some areas.

In her speech the Minister spoke of the importance of bringing the Dáil back early for this legislation. The Dáil was rushed back in January to discuss this Bill. A Bill like this probably would not even get on to the third or fourth page of a national newspaper in another country because issues like this authority and other patients' rights would be accepted as a given and would not even need to be discussed, but due to all the scandals and bad news over the past few years in this country it must be discussed and this necessitated calling the Dáil back early to debate it.

Despite all the Minister's hype about bringing the Dáil back early a month ago to discuss this Bill, we are still here discussing it. It was off the agenda, then it came back on the agenda for two weeks and we did not get to it, and here we are a month later discussing an urgent Bill. We had proof last night of what can be done if something is urgent. If this was so urgent and at the centre of the Minister's heart, why are we still here a month later discussing it?

In her speech the Minister stated that step by step, in the reform programme and legislation, we are leaving behind the old system. As I mentioned earlier, I am not convinced we have left behind the old system and in some cases it is a matter of step by step in reverse. Efforts to achieve accountability are going backwards. We can no longer obtain answers in a few days regarding the problem of a client — doing so can now take months. It can take and has taken three or four months to obtain figures on waiting lists. We are going backwards in terms of accountability and responsibility for the health service. The Minister seems to have put the problem to one side. Responsibility for every second parliamentary question on the health service, if not more, is passed to the HSE.

The Minister stated we are leaving behind the old system in which vital information on health was not gathered comprehensively, and in which the assessment of new technologies and new drugs was not done clearly and systematically to serve the interests of patients and taxpayers alike. Let me hone in on new drugs. There has never been a full debate on methadone in this House. I have tried to obtain information on it left, right and centre, but it is very hard. The buck is being passed between the Minister of State at the Department of Community, Rural and Gaeltacht Affairs, Deputy Noel Ahern, and the Minister for Health and Children, Deputy Harney. Nobody will make a decision on it. The State is spending vast sums on methadone without debating fully whether it is the best product and examining fully other drugs and initiatives in other countries. We are not trying to take people off methadone and not doing so can be serious. Doctors are prescribing it to get patients off heroin, which is a step in the right direction, but patients should not remain on it. There are thousands of people taking methadone with no date specified on which they are to stop taking it. This incurs a high cost and a better approach could be taken.

The Minister listed all the changes she is making and the initiatives she has implemented. It seems she operates a system used in business called "just in time" in that she seems to implement many initiatives just in time for the election. It is a shame because I believed she would do a lot more for the health service.

One function of the Health Information and Quality Authority is to set down standards on safety and quality for all services. What will happen if those standards are broken? It is not clear in the Bill. Will the authority set down further standards regarding the delivery of services?

If an elderly person needs an assessment to have his house adapted, enter a nursing home, obtain treatment or receive a visit from a consultant, he will be put on an endless waiting list and may have to wait from one to 15 months. At no stage is a red flag waved to indicate this period is too long. It is waved in respect of the national treatment purchase scheme but in other areas one could have to wait a long time just to be assessed or obtain information or an appointment. A standard should be set down to ensure the existence of a set waiting time. If a patient must wait beyond two months to see a consultant, a red flag should be waved and the HSE should step in and provide the service in another way, be it privately or otherwise. We must have standards and patients need to know what is in line for them.

The Health Information and Quality Authority will be able to carry out reviews to ensure best outcomes and value for money for the resources available to the HSE. What powers will the authority have in this regard? If the reviews highlight a problem, what action will be taken? Will another report sit on someone's desk or will it be forwarded to the Minister? Will the authority demand action on foot of the information it gathers for its reviews? There is no point in reviews if they do not achieve anything.

The authority is to evaluate information available on services provided by the HSE and other service providers and on the health and welfare of the population, identify information deficiencies and advise the HSE and the Minister accordingly. It should advise the public and not just the HSE and Minister. A body produced a document before the Christmas holidays on the future of Irish in schools. Neither I nor the public has seen it because it is with the Minister. If we are to have an authority to prioritise patient safety, it should surely make its advice available to the public first, or at least at the same time as it is received by the HSE and Minister. It should not be handed over on the quiet in a little document to be read by someone when he or she has time to do so. This defeats the purpose.

The chief inspector will have the power to operate and register the various centres. The Minister stated registration details will be available to the public on the Internet. Not everybody has access to the Internet although we wish they did. Ministers have a habit of talking about the Internet, but retirement groups, Active Age members and representatives of the Older and Bolder campaign tell us at their meetings that not everybody can use it. We must therefore make registration details available from other sources, be it in hospitals or HSE buildings. It is not satisfactory that the Minister's speech refers to making information available on the Internet and nowhere else.

Under section 50, the chief inspector can cancel a registration, vary a condition of registration or impose new conditions. Will the legislation leave the cancellation of registration straightforward? I am not convinced it will. Will there still be a grey area that will not be addressed for a long time? I want this clarified because it is important.

Hospitals, nursing homes and health and social service departments can best be described as places where patients go to receive care and get better. They trust the system to keep them safe, look after them and make them feel and get better. Sadly, this does not happen in this country. The trust has been abused and patients have been let down, albeit only in certain places. This is why we are debating this Bill. Thanks to my colleague, Deputy O'Dowd, this matter has been highlighted in recent years. It is a case of "recent years" rather than "recent weeks", yet nothing has been done. In some cases, it is question of too little, too late, but at least we are moving on.

The needless death of Monaghan man Pat Joe Walsh from a curable ulcer occurred because of the apparent lack of a bed in neighbouring hospitals. While hindsight will not bring him back, sadly, it proves that several hospitals were available. Pat Joe Walsh and countless others like him should not have died, yet they did. The question of why is still unanswered and many people from Monaghan and others with similar tales are still asking it. Will the authority prevent needless deaths, protect patients' rights and make information available? Patients are not being looked after and do not feel safe.

MRSA and other superbugs such as the winter vomiting bug have infested hospital wards, striking fear into vulnerable young people and cherished elderly, who believe a routine hospital stay may result in their acquiring a more serious and vicious illness than they already have. This is certainly not right or fair and should not be acceptable in 21st-century hospitals. However, it seems to be acceptable because not enough is being done to stamp it out. Getting rid of MRSA is not rocket science. There are some simple and complicated solutions and we could certainly make a real effort to implement them. The authority has a role in ensuring MRSA is stamped out.

The MRSA problem has been neglected in recent years and has not been solved quickly enough. Announcements were made to the effect that money is being spent on it, but there is no real effort to stamp it out. We published a Bill on the matter and launched an initiative but we have been debating it for months. For a start, a person responsible for overseeing cleaning should be put in charge in each ward. This is the number-one requirement.

Many hospitals and health centres have contract cleaners who clean other buildings on certain days of the week. They are not specially trained to clean hospitals and theatres and therefore do not clean to the high standard required. We should address this. Years ago, there were in-house cleaners who worked with the nurses, thus keeping the hospitals clean. In some cases, extreme measures were taken, nevertheless we must ensure that professional people who know exactly what they are doing are put in charge. Their expertise should be in the area of cleaning hospitals and hospital equipment. This is very important.

The Teamwork report sets out the future of services in the north east. It is a worthy document in its own right and has much good content. It indicates where we want to go and I and my party fully support it. It recommends building a brand new regional hospital to serve the north-east region and this makes total sense. However, at best, this will not be built for seven or eight years and will probably take ten to 15. The document specifies a target of approximately ten years. The authors of the report, which has been accepted by the Government and HSE and which is being enforced, recommended a reduction of services in many of our hospitals. One of the short-term aims of the report is to remove the emergency surgery facility from Our Lady's Hospital in Navan, County Meath. This has effectively been done but nothing better has been put in its place. Patients have been diverted from Navan Hospital to Our Lady of Lourdes Hospital in Drogheda, which is under unbelievable pressure and cannot cope. This Bill provides for patients' rights and protections, yet the patients will be put in danger because services are being withdrawn from existing hospitals in Navan and elsewhere before a new and better facility can be built. That is a disgrace and will result in people's deaths. The Minister of State has visited Enfield to open creches, so he is probably aware that it is a long journey from there or Ballivor to Drogheda.

See this speech in context