James Reilly (Dublin North, Fine Gael)

I did not speak during the Deputy's speech and ask that the same courtesy be extended to me.

I have a question for Dr. Devins and those on the other side of the House. Why is it only when the Minister's job is on the line that we see this emotion, devotion and talk of patient-centred care? This Minister talks the talk but she does not walk the walk. She provides over a health system that runs from crisis to crisis, is dysfunctional and fails the people of Ireland who pay for it. Yesterday she talked tough about not going off the pitch and she has done the same thing again tonight. We expected no less. If anything has become clear in recent months, in Portlaoise and elsewhere, it is that talking a good game is not enough and it is no match for ministerial action.

The Minister has described herself as having responded speedily, quickly and thoroughly but on 2 November she released a statement that the review phase of the radiology breast diagnosis would be completed within a week. It took 18 more days and only on 20 November, when the Minister, Deputy Harney, was preparing for parliamentary questions, was she finally given the results of the review and the terrible news that two more women had been misdiagnosed and that the total number of women who now had cancer was nine. Like the Minister, I wish those women well and a speedy and full recovery.

I do not know how the Minister can describe her actions as speedy, quick and thorough. On 7 November, during Dáil statements on the Portlaoise situation, the Minister said that Dr. Ann O'Doherty had been asked to look at all mammograms, ultrasounds and anything else relevant. However, she says it was not until 22 November, at the Joint Committee on Health and Children, that she realised a review of ultrasounds was taking place. How speedy, quick and thorough was that?

On 7 November, during the same Dáil debate the Minister said the last thing one could accuse Dr. O'Doherty of was not being independent. Yet, on 22 November, at the Joint Committee on Health and Children, the Minister said she became aware two weeks previously that she was on the interview board. How can somebody who was on the interview board that appointed a consultant on administrative leave, and who may have expressed reservations about the competence of the consultant, not have a potential conflict of interest or be deemed to be an independent arbitrator in this case? This is hardly speedy, quick and thorough action.

The Minister has a serious credibility problem. She came to her Department three years ago with a strong reputation as an achiever, and nobody will deny her past achievements, but today is not about reputations. Today is about the health of a nation and how the State, through the Department of Health and Children that is run by the Minister, and the HSE deliver health care. The Minister designed the HSE with her Cabinet colleagues and implemented it in the Health Bill on 23 November 2004.

In January this year the Minister said there would be no cutbacks in the health service but in September she introduced them. She said patients would come first and that they would not be affected by the cutbacks, but operations were cancelled throughout the country. The Orthopaedic Hospital in Navan was closed and the Minister and HSE made a feeble attempt to suggest only six people would be affected in a unit that carries out 180 operations per month. At least 150 operations were cancelled. The Minister suggested cutbacks would not affect patient care, but home care packages were removed — one from a disabled child suffering from Down's syndrome and cystic fibrosis. The Minister took home help from the elderly and 22,000 bed days were lost in Beaumont Hospital last year, not because of late discharges on Saturdays and Sundays but because beds in the community were not availed of. Those 22,000 bed days are the equivalent of having two wards, each containing 30 beds, closed for a full year.

In 2004 the Minister promised to tackle the crisis in accident and emergency departments through a €70 million ten-point plan but over a year later the number of people on trolleys had doubled. The Minister declared the crisis in accident and emergency departments a national emergency. The reality facing pensioners and seriously ill patients every day involves long delays in overcrowded accident and emergency departments where they lie in fear of contracting methicillin-resistant staphylococcus aureus, MRSA. This is quite a record for the Minister to be proud of — she should hang her head in shame. This Minister cannot provide dignified care for our elderly loved ones in Irish hospitals after ten years of unprecedented wealth.

The Minister promised cervical screening would roll out on 1 January and I pointed out six weeks ago that this was most unlikely to happen. There is only one accredited laboratory to read smears and some tests are being outsourced to the United States. There is no attempt to build up resources and services in the State. Sending smears to the United States will lead to further problems because it increases the likelihood of errors of interpretation on this side of the Atlantic. The Minister has made no arrangements with family clinics and GPs to take smear tests. It is no wonder the promised cervical screening programme is now delayed until March 2008. Can this be achieved, given the lack of preparation?

Women continue to await the roll-out of the BreastCheck programme, which was promised many years ago but has been subject to forever moving deadlines. The Minister promised centres of excellence for cancer care by 2011. However, following statements by Professor Drumm that they could not be delivered until 2015, through public private partnerships, she panicked and announced they would be ready by 2010. Has anybody asked Professor Keane whether he closed down existing services in British Columbia before opening new services? I doubt very much that he did.

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