Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

I move amendment No. 11:

In page 13, between lines 19 and 20, to insert the following:

"(c) to report on any failure by the Executive to take appropriate enforcement action in the event of non-compliance with the standards referred to in paragraph (a);".

Tá brón orm nach raibh mé ábalta a bheith i láthair ag tús an díospóireacht ar an Chéim seo. I am sorry I was not in the Chamber for the commencement of Report Stage, but I had to attend a meeting.

This amendment is designed to strengthen the hand of the authority to hold the Health Service Executive to account. It provides for ongoing monitoring by the authority of the executive's compliance with its rulings. The HSE must be fully held to account. There can be little doubt in the minds of any in this House that the HSE has become what I can only describe as an enormous and unaccountable quango, with no democratic accountability whatsoever. With all its flaws, the former health board system had a much greater level of accountability and transparency, most importantly courtesy of the input of democratically elected members of local authorities, who played an important role in its work.

The HSE has become an enormous and unaccountable quango and that is perfectly illustrated by the way in which information relating to its work is now more difficult than ever for Members to ascertain. Members of this House will know that only too well. We have seen the ever-increasing percentage of questions tabled to the Minister for Health and Children and the Ministers of State at the Department that are referred directly to the HSE. The figure in this regard represents an increase of almost 35% on what applied during the previous Minister's term in office. Despite the repeated promises and commitments made by the parliamentary affairs division of the HSE, we continue to encounter inordinate delays in responses to parliamentary questions. In my experience, these delays are generally measured in months rather than days or weeks.

I and other Members warned of this lack of democratic accountability when the health boards were abolished. In return, the Government promised greater efficiency and committed to the better delivery of health care services across the board, but the opposite has happened. We now have a seriously deficient health service at every level, from acute hospital services across the entire range of services. There are grave concerns and difficulties are experienced by service users. There is great discontent among direct employees, those who deliver the service at the coalface, and this has been particularly exemplified recently by the members of the Irish Nurses Organisation and the Psychiatric Nurses Association.

The public hospital system is clearly in a deepening crisis, the primary care strategy has been virtually abandoned, MRSA is endemic and the HSE is being used to implement the privatisation of services through what can only be described as the infamous co-location project, which is very much the baby of the current Minister and which reinforces the two-tier system that is at the root of many of our problems. The HSE and the Minister must be held to account. The HIQA may provide the means to do this, and therefore, I urge the adoption of this amendment. I hope the Minister of State, Deputy Tim O'Malley, is in the position to give us an affirmation of its acceptance.

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