Enda Kenny (Mayo, Fine Gael)

I support the motion that this House has no confidence in the Minister for Health and Children, Deputy Mary Harney. The principal reason she should resign is her failure to oversee in a competent manner a health system that provides proper care for patients. She has failed to lead our health service, failed to deliver on commitments made by her own Government, and ultimately failed those who use the health service, especially the women of the midlands who, scandalously, have been left waiting for further medical assessment.

However, we are used to words from the Minister, Deputy Harney. Three years ago she promised to solve the accident and emergency department crisis. Today there are 251 people on trolleys, yesterday there were 257, that is, 50 more each day than the same days three years ago.

In January of this year she stated there would be no cutbacks in the health service and that patients would not suffer. In September, she stated that the cutbacks would not hurt patients but they did. Operations were cancelled up and down the country. Home helps were withdrawn. Home care packages for children with a disability were cancelled and suicide prevention training courses were cancelled also.

However, on Thursday last, at the Joint Committee on Health and Children, the killing casualness of the announcement exposed how shallow and hollow the words, promises and rhetoric of the Minister have been. The news that 97 women needed further medical examination but had not been told, exploded once and for all the myth of Deputy Harney being the tough, effective and caring Minister on top of her job. The decision to delay informing these women until the HSE had the "cohort" it required and the reference to women "jamming up the lines" revealed the hard cold truth of the Irish health service under this Minister and revealed how concern for the system outweighs concern for the patient.

The surge of action on Friday when the Minister's political neck was on the line demonstrated where her priorities lay, the protection of her political career. Of course, an excuse was rolled out. Is there not always one? This time it was "a communications failure", but could the Minister have anticipated this?

Last night she referred to reports produced before the HSE was set up. One of those reports, the 2003 Brennan report, could have forewarned her. Commenting on the relationship between the Department of Health and Children and the HSE, Professor Brennan stated "it will be essential that the Department be closely in touch with the on-the-ground reality of policy implementation". In a prophetic piece, Professor Brennan went on to state "if the relationship between the two parties does not work properly, it could substantially compromise the capacity of the health service to deliver its objectives". How right she was.

The Minister, Deputy Harney, had yet another warning about the need to stay on top of her brief in the Travers report of March 2005. Mr. Travers made clear recommendations. In future, he stated, she should "probe, in an insightful and effective way, areas of policy implementation, operations and administrative difficulty". He added that the Minister should "insist on full and periodic briefings on key issues of policy and operational performance". In the Minister's press release about that matter, Deputy Harney stated "'issues of singular importance' ... should be identified and dealt with in clear language and with a clear purpose and remedy".

How did the Minister measure up? Did she deal with Mr. Naughton's letter of 2005 "with a clear purpose and remedy"? She did not because she did not even read the letter. When cancer services in Portlaoise were suspended in August this year, did she deal with this "with a clear purpose and remedy"? She did not. She spoke a great deal about how concerned she was for the women involved, how they were her priority, how they would be cared for and how they would get all the treatment. It sounded like clear purpose and remedy, but the reality was different. The Minister retreated to her Hawkins House ministerial suite bolstered by a €25,000 increase in salary and ignored the issue until just before she was about to appear before the House to answer parliamentary questions.

By her own admission, she and her Department did not know about the ultrasound review, even though it is set out explicitly in the terms of reference. Did she even read these? By her own admission, she could not get information on the ultrasound review on Wednesday, 21 November. This is an appalling admission for any Minister.

By her own admission, she was able to instruct her officials to tell the HSE to hold a special clinic in Portlaoise on Saturday last. When political will was shown, the HSE's plan for clinics in Dublin were also overthrown. By her own admission, that special clinic only took place because concerned cancer specialists volunteered their services. That is a new version of a dig-out for the Department of Health and Children — specialists' goodwill instead of the political will of a Minister. Contrast that with the comment of Professor Keane who stated that the system should be that a cancer suspect would get immediate attention and not be left hanging around with weeks of trauma, pressure and stress, like the Minister allowed happen to those women in Portlaoise and the midlands.

The Minister, Deputy Harney, states repeatedly she will not walk off the pitch. The reality is that she was not on the pitch when she was needed. To continue that analogy, in any credible and functioning Government she would be dropped from the team by now. She did walk off the pitch and she abandoned leadership when she was pursued by former Minister, Michael McDowell SC. She is now, with diminished authority, in a diminished ministry.

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