Ciarán Lynch (Cork South Central, Labour)

"I beheld the wretch — the miserable monster whom I had created." That is a quote from Mary Shelley's Frankenstein which goes to the centre of this debate and asks who is the villain of the piece, the entity created or the creator of the entity? The HSE is the creation of the Minister and like Shelley's Frankenstein it has grown completely and utterly beyond her control.

The Minister told us her reason for creating the HSE was to allow a health service that would be free of political interference. Instead, she gave us a health service free of political accountability and a health system hamstrung by ideological interference, which sees the improvement of public health care through the development of private hospitals in order to profit from sick people.

If one were to have reservation or concern about tonight's motion, it could relate to who will be the Minister's replacement. Would it be Deputy Martin Cullen of electronic voting fame, provisionally licensed Deputy Noel Dempsey or Deputy Harney's predecessor and serial announcer, Deputy Micheál Martin? However, any concern about the Minister for Health and Children's replacement can only be seen in the context of the idea that making mistakes, no matter how great or regular, will not be a deterrent to being a Minister in this Government.

Accountability and delivery are at the centre of this debate, and I make this point with reference to the Minister's reply to this motion last night. When the Minister speaks on health matters, she does so with conviction and a sincerity that may well be genuine. Underpinning that sincerity is a clear ideological position which sees a solution to our public health care service in privatisation. It is that contradiction which "has us now where we are", as the Minister herself stated.

We can all acknowledge that there are many good parts to the health service. Thousands of people are successfully treated for serious and complex issues every day. Those successes are not attributable to the Minister but she is accountable for them. The Minister sets the direction for the health service, disburses money, approves health care systems and appoints, implements and manages them.

She may not be directly responsible for these systems but she is ultimately accountable for them. She is not responsible for the day-to-day operation of the HSE but she is accountable for it. It is simply unacceptable for the Minister to state, as she did last Friday, that there are communications issues to account for her lack of knowledge.

It is unacceptable that she could go into a meeting ignorant of the fact that 97 women were to be given the most appalling news on that evening's news bulletins. It is unacceptable that the Minister for Health and Children feels entitled to be one remove from health care issues.

For example, when a Deputy tables a parliamentary question to the Minister, it is invariably kicked over to the HSE, which will reply not in a matter of days but perhaps weeks or months. That reply is not entered into the public record of this House and may never come to the attention of the Minister or her officials.

See this speech in context