Bernard Durkan (Kildare North, Fine Gael)

Anything I say should not be taken as a personal criticism of the Minister for Health and Children, Deputy Mary Harney, but I strongly disagree with one remark she made. The Minister said people will drive a sick child almost anywhere to obtain treatment but that is not true. People with a child in need of urgent treatment will drive to the nearest hospital wherever it may be. Until the people on the other side of the House, who control these services, recognise this fact they are wasting their time.

We heard this sort of rubbish on countless occasions with regard to the location of the new children's hospital and one of its selling points was that it is on the Luas route and had train services nearby. Nobody brings a child to hospital in an emergency by train, bus or other forms of public transport. In the middle of the night, countless parents are forced to take their children to hospital and in such an emergency they will always choose the nearest hospital available.

In past times, when many hospitals were available around this city, doctors would refer a patient to one hospital, then another and another until he or she found one that could cater for his or her patient. This facility is gone because of economics; it is deemed more efficient to cut back and remove hospitals. This idea of big is beautiful was adopted in the UK and it failed. Big is only beautiful if a selection of alternative services is available and competition exists.

I disagreed with the Minister long ago about the idea of one health board for the entire country and it still will not and cannot work. She may compare ours to any jurisdiction she wishes but the idea will simply never work. Instead the HSE will be subdivided into mini regions with various people fighting turf wars within the system. There is no accountability because although we can put questions to the Minister in the House, she can no longer answer for the health service. Instead when we put a question we receive a reply, sometimes curt, a week later merely stating that it is a matter for the Health Service Executive. The HSE seems not to understand why we ask such questions but we have a right to do so because the public demands to know.

The HSE is a department built on reports — the Minister's predecessor introduced the ten year strategy some years ago, then came the Hanly report and the Brennan report. How many other reports will there be before action is taken? This situation has emerged because the needs of the patient are not central to the health service; no reference is made to the convenience of the patient. Does anyone consider how painful it is to wait three, four or five months for a hip operation? Countless people in my constituency and others are in that situation, although the scoping reports do not seem to pick up on them. In the recent general election we met many such people but we received some fairly curt replies from the HSE when we raised their questions. I want to make it clear that it is a Deputy's job to raise questions in this House when a constituent has raised it with him or her. We have a right to accurate answers.

I believe the health service is best served by an available, accessible, accountable modern and efficient network around the country, but this does not seem to be the direction the Minister is taking. Instead the Minister seems to be applying plasters to the service's wounds. Naas General Hospital was mentioned as the most modern hospital around with its state-of-the-art, clean air theatres. Why are they not being fully utilised and for whose convenience are they being kept empty? It is certainly not for the convenience of the patients as they are ready for treatment.

Why is it necessary to have waiting lists? Is it not as easy to simply perform an operation straight away, within a week of referral? It is surely as easy in the first week as it is six months later. If a procedure must be undergone in any event, what is the benefit of keeping a patient waiting? I compare the waiting time here to the experience I heard some time ago of a patient undergoing a procedure in another jurisdiction. The patient had an X-ray, received the result of the X-ray within two hours and was then referred for the procedure. A person might have to wait three months, six months or even a year to undergo tests here. The issues speak for themselves. We need to get back to basics and deal with patients' needs as opposed to providing for the convenience of an internal system.

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