Mary O'Rourke (Longford-Westmeath, Fianna Fail)

I have no vested interest in this issue because even though Athlone is bursting at the seams, it lacks a hospital. We have an excellent care service which treats older people with dignity and love but we have no hospital. Centres of excellence make sense but the transition must be charted from what we have now to the point at which the centres are established. People will otherwise be left in a vacuum, unsure of whether they should continue to attend their local services or wait until the magnificent centres of excellence appear out of the gloaming to the wonder of us all.

I recall being told in the 1980s that mental hospitals should leave their Victorian settings so that people could live in private houses with care assistants. The mental health system eased itself in that direction but it took a long time to do so. In the meantime, the mental hospitals remained open for those who were not ready to move to private homes. The centres of excellence, about which we feel guilty if we are not supportive, are somewhat of a mirage. It is as if one is in a desert and constantly sees a great city.

I am in despair about the health services in Ireland. Thankfully, I have not yet had personal cause to experience them, although members of my family who have passed away were beautifully treated in the Mater Hospital. I do not know how the Minister can continue because there are always dragons in her path which must be slain. She has made a good effort at slaying them but fresh dragons keep emerging. Will Nirvana or Hy Brasil ever appear? Will we ever see the promised land in health? I do not think so, regardless of how much admonishment we receive from Professor Drumm or the Minister, although hers is given kindly.

Deputy Burton spoke about how the HSE makes us feel when we receive correspondence from it. By the time we receive the letters, weeks have passed and we have forgotten the query and must tune into the issue once again. I received a letter which began by asking me if I realised that I had complained about a care home for troubled adolescents. Of course I was aware it was a care home but that did not explain why the young inhabitants were not being properly minded. I was made out to be unfeeling because I dared to bring it to the attention of the HSE that the young people were running wild in the town. The letter was astonishing in its implications.

We need to see exactly where the centres of excellence will be located. I am puzzled because Professor O'Higgins outlined 12 centres of excellence but there are now eight. We know where the remaining eight are to be located but I would be happier if I knew what happened to the missing four. What pitch has been made in respect of the finance for the centres, given that they will be hugely expensive? Have we made allowances for that in our financial forecasts? The hospitals which are currently providing good care should continue their operations. We cannot suddenly send everybody down the road to centres of excellence without allowing for the phasing outof the centres where services are currently provided.

I wish the Minister well but there are so many dragons in her path that I do not know whether she will have sufficient swords to slay them. It is depressing that the dawn is always supposed to be brighter if we deal with the consultants or mollify this or that group when the dawn never arrives. The health services remain in the doldrums despite all the positive stories which appear to give hope to people. The HSE has become a giant which cannot come to grips with its many parts. The Minister must preside over it because I do not agree that all responsibility should lie with Professor Drumm. We will now have another person like Professor Drumm, the czar for cancer, and all the problems will be heaped upon him. I wish Professor Tom Keane well and hope he has a kindlier manner, a better way of approaching people and an appreciation of the enormous worry all this has caused. I wonder how women who have had mammograms sleep at night. If they sleep, their first thought when they wake up must be "Oh my God, am I due, am I one of the people who is going to be called out or will I have to go again? Is that what my fate will be?"

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