Bernard Durkan (Kildare North, Fine Gael)

I am glad to have an opportunity to speak on the Medical Practitioners Bill 2007. Like Deputy Fitzpatrick, I should declare an interest — I was a member of a local health committee and the local health board for many years. As I listen to this debate, I have to compare the problems the House is considering with the problems it used to have to manage. In the bad old days when this country had no money, patients could go into hospital and be attended to immediately, without having to wait for beds to become available. Nowadays, patients have to wait for the triage group to meet, assess them and pick out the must urgent cases. While I accept the need to prioritise, it is not right that patients with less important problems are pushed to one side, or onto hospital trolleys, when people with more urgent cases arrive. Such a description of what is happening may seem like a simplification, but that is not the case.

Unlike other Members of the House, I think the Health Service Executive cannot and will not work. The HSE is incapable of dealing with the needs of this country's health service. It is the brainchild of people who spent years comparing the requirements of this country's system with those of the system in the greater Manchester area. The two areas should not be equated in any way because of the colossal differences in terrain and distances. While the greater Manchester area has virtually the same population as Ireland, it is compressed into a much smaller area. A further mistake was made when people started to run the health service as a business. Some officials are more concerned with ensuring the service is running than catering for the needs of patients.

When I was first elected to this House, I heard Members giving many reasons for the closure of hospitals. Medical personnel and health service experts from all over the world argued that there were too many hospitals in the country. They proposed that we should concentrate our services in big hospitals. It was absolute rubbish. I do not care who the experts were — their ideas have not worked and will not work. They wrongly believed that adjustments in economies of scale would lead to benefits all round. Such changes have led to congestion and bedlam, however. People are stepping over each other because too many patients are concentrated in the same place at the same time. These problems have resulted from stupid planning over many years on the part of so-called experts who seem to know about everything other than the subject they should know about.

This is a social issue, rather than an economic one. Services need to be delivered as they are needed because it is a matter of life and death. We must use modern technology to upgrade the system, which needs to be more responsive. I do not think the Health Service Executive will do that, however. Given that the HSE covers the public and private sectors, its establishment represented the privatisation of the management of the health services. It was presumed that the new structures would work, even though they have not worked previously. One of the first mistakes it made was to place an emphasis on focus groups, which are needed now that nobody is in a position to tell HSE management what is going on. They dumped the red-necked, red-nosed politicians when they abolished the health boards. They thought we were too expensive and did not know anything anyway.

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