James Reilly (Dublin North, Fine Gael)

I wish to start on a positive note. I see my old friend, Mr. Tom Mooney, there from the Department of Health and Children. He knows that I always try to see the positive side of things. I welcome the fact that Fine Gael pressure has resulted in the cuts in surgeons at Sligo General Hospital being forestalled for three months at least. We have also stimulated the resumption of dental services at Bluebell and Inchicore, although this will not happen until November. This shows that the Government can act when it has the political will to do so. The Taoiseach and the Minister for Health and Children now believe that if they say something often enough, then it is so. We are back to the good old days. "There will be no cuts" was the mantra of the Taoiseach and the Minister on Newstalk before the election a few short months ago. Now we see the truth, however, which involves cuts of frontline patient services all over the country. They say the cuts will not affect patient care, but operations have been cancelled at Cavan. In addition, reduced bed availability means more patients are on trolleys in accident and emergency in Galway. Cardiology clinics in Crumlin for small babies and sick children are under threat in October and November.

What about the new cancer strategy for the future? We dismantled the existing service with immediate effect, only to find a week later that the western HSE has deferred 184 posts, which will reduce breast cancer services from five to three days a week at its proposed designated centre of excellence. What provision has the Government made for transport services from the hospitals that are closing down their services and transferring them to centres of excellence? I am told that little or no such provision has been made as the transport budget has actually been cut. The Minister refuses to listen to her own colleagues. Deputy O'Rourke said she does not support the PPP process or bilocation, which she believes cannot deliver the cancer strategy. The Minister's Cabinet colleague, Deputy Ó Cuív, cannot make head nor tail of it. He said the HSE was impossible to deal with. In deference to the Minister I will not mention Tallaght. Deputy O'Connor, who is always a reasonable man, tells the Minister that the HSE should get its act together. The Minister of State, Deputy Devins, expresses concerns regarding HSE cuts in Sligo General Hospital.

Why is there no health committee in this Dáil four months into the new term? Is this an example of how seriously the Government treats health issues? Why have we had nine months of mismanagement of the HSE budget? As the Minister's own Government colleague asked, what happened to the monthly control to which the Minister alluded earlier? Why after nine months do we find panic stations with frontline services being cut? We have seen operations cancelled at Cavan-Monaghan hospital. I welcome the representatives of the Cavan-Monaghan action group here. Deputy Crawford and the Monaghan hospital action committee have been fighting tooth and nail to hold on to existing services, and who would blame them?

This is a case of live horse eat grass — you can have it tomorrow but we are taking away what you have today. Anybody who buys into that is surely naive. Serious operations are being cancelled and some people are waiting up to two years for their operations. It is objectionable that a HSE spokesman on the radio describes these as minor operations. Everyone waiting for the operations would require a general anaesthetic, a serious event in itself carrying its own risks and morbidity. These people, and their families, suffer stress and worry as they prepare for their operations and it is not good enough that they should be cancelled on a whim. This does not serve the people.

A total of 41,000 people are on waiting lists and one of the longest lists is at Beaumont Hospital. For the Minister and the Taoiseach, wherever he is tonight, the reality is that today at Beaumont nine ambulances were tied up waiting for patients to vacate trolleys. One patient collapsed and had to be treated on the floor of the accident and emergency unit. What happened to my parliamentary question asking that spare trolleys be left for ambulances?

Under Charles Haughey Fianna Fáil had a campaign slogan, "Health cuts hurt the old, the sick and the handicapped". That is particularly applicable in the current climate of swinging cuts to frontline services. Another phrase from that era sums up the Government's attitude to the health services, "GUBU" : it is "grotesque" that patient care is sacrificed for supposed fiscal rectitude when there is an alternative available in the form of delivering efficiencies from the burgeoning bureaucracy in the health service. It is "unbelievable" that Ministers persist in denying that patient care will be affected by cutbacks when it is clear that an attack on frontline delivery affects patient care. It is "bizarre" that the Government can announce a strategy on cancer one week and cut the delivery of cancer services the next. It is "unprecedented" that a Minister and architect of the Health Service Executive should now abdicate responsibility for its functions saying it is impossible to deal with.

The Government's attitude to the HSE is that of Frankenstein to his monster, it is prepared to reject it or use it as a shield when it suits. It is not unprecedented, however, that severe cutbacks should closely follow the return of Fianna Fáil and the Progressive Democrats to Government. Despite all the defences they have put up it cannot be denied that patients are being punished for the overspending of a Government agency. I ask the Minister again to put the patient first and ensure that frontline services are not affected by these cutbacks.

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