Joan Burton (Dublin West, Labour)

I thank Deputy Jan O'Sullivan for moving this motion.

The former US President Harry S. Truman had a sign on his desk which read "The buck stops here". This Government seems intent on ignoring that old-fashioned idea of accountability. The buck stops anywhere but with the Taoiseach and the Minister for Health and Children. The shameful goings-on in our cancer services are probably the greatest scandal to face the health services since the blood contamination crisis. What we know now points to systemic failures, not just isolated mistakes of administration. Systemic failure must be the responsibility of the Minister and the Government of the day. These failures are ultimately life-threatening and life-shortening for a significant number of women, as was the case in the blood contamination crisis.

All the advice that women are given to reduce their chances of dying from breast cancer involves mass screening, early diagnosis and prompt treatment. The women in Portlaoise and the women in Cork University Hospital did what they were advised to do and are now in some cases left in an unbearable situation. They placed their trust and confidence in the HSE, in the health services and in the Minister for Health and Children. The failure to diagnose them properly will undoubtedly lead to much physical and emotional suffering and pain for the women and their families.

First Portlaoise, now Cork University Hospital, where up to 16 women may have been misdiagnosed. This prompts the question. Is what is happening in Portlaoise and Cork simply the tip of an iceberg? Is there systemic failure in the health services? Given what we now know, is it adequate that the HSE should be investigating itself? If one looks back at comparable situations such as the contaminated blood scandal, it was only when there was a full independent examination that the truths and complexities of the situation began to emerge.

The key questions now are as follows. Who knew what, when and how did they respond? Were at-risk women left to wait an unnecessarily long time? Why did 97 women, the Minister for Health and Children and Professor Brendan Drumm find out that all was not well only in a question and answer session in the Oireachtas Joint Committee on Health and Children on Thursday morning last?

On 29 August 29 the HSE informed the Department of Health and Children and the Minister that it had ceased the provision of breast radiology services at Portlaoise, placed a consultant radiologist on leave and set up a review of all breast radiology diagnoses at the hospital from November 2003 to August 2007. This review is to be carried out by Dr. Ann O'Doherty and is due at the end of this month, but we still do not have it. It appears that the HSE, in early September, had asked the local surgeon to review the clinical notes of patients who had ultrasound procedures. Therefore, there were two reviews being carried out independently of each other, but apparently unknown to the Minister and the chief executive of the HSE.

The HSE was developed as a flagship model of a centralised health service. In designing this creature, the Minister confined her role, by choice, to policy, openings and speeches. Like Napoleon, she made provision for an army of administrators who would know everything about the system at any one time, but the sad reality of her creation is that the Minister is now out of touch and the HSE is out of control.

How many staff does it take to change a light bulb in a hospital? That is a fair question. How many Ministers and Ministers of State in the Department for Health does it take to address a crisis? She and her team of four junior Ministers cost the taxpayer in excess of €2 million a year, while the senior executives in the HSE also earn high salaries. It begs the question, are they worth the wages that the taxpayer is paying?

In this tangled mess, three elements stand out: first, the Minister's ideologically-driven desire to have a full for-profit health care industry in this country; second, the role of special interests, corporates and investors seeking the lucrative tax breaks and contracts arising from the Minister's initiatives such as co-located private hospitals; third, the loss of morale among frontline workers such as doctors and nurses who are becoming increasingly alienated from a Minister and a management that appears weighed down by incompetence and over-administration. There is now a toxic mix at the top of the health service — arrogance, notions of impregnability and exhaustion as one crisis follows another.

The worry used to be that staff in hospitals were not washing their hands. Now we see the Minister washing her hands and refusing to take responsibility for the crisis.

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