Jan O'Sullivan (Limerick East, Labour)

——and it will be impossible to get her back into the public system. Another issue, which I raised previously, is where there is a medical expert in a rare specialty area. How will that person's clinical expertise be shared between the public and private system? That has not been clarified.

Another aspect to this issue came to light this morning, at the meeting of the health committee. The meeting was attended by Professor Tom Keane and discussed the plans for cancer services. It was a great opportunity to have him attend the meeting and we were given plenty of good information. One of the matters discussed was transport, and the difficulty for patients who had to travel to cancer centres — Professor Keane did not wish to call them centres of excellence. He told us that in British Columbia a patient's tests are scheduled to be carried out in a single day, so patients are not delayed there for too long.

There are also places adjacent to the hospital where patients can stay, if necessary. The cancer society in British Columbia is strongly involved in organising this accommodation for patients while they are undergoing tests and so forth. Would it not be great to have enough grounds surrounding the cancer centres to build places for people to stay, so they would not have to occupy expensive acute beds? While they are having tests carried out they could stay in these cheaper forms of accommodation which do not have the intensive support an acute hospital bed requires. I question the use of public hospital grounds for private hospitals and clinics. These grounds could be needed to provide facilities to accommodate patients who have travelled far for cancer tests or cancer treatment. A person who is attending the centre for radiotherapy, for example, could stay in this less expensive type of accommodation.

Similarly, last week we were told there are approximately 300 bed blockers — a term I dislike — in the Dublin area. These people do not need to be in acute hospitals and could be transferred into the community. The public land could be put to good use by using it to provide public beds for patients who are currently needlessly occupying acute beds. Another use for that land is in the area of maternity services. The capacity of maternity hospitals is under pressure due to increasing birth rates. In my constituency it is planned to move the maternity hospital to the grounds of the public mid-west regional hospital. However, it is planned to put a co-located hospital there, which will take up some of the valuable public land which could be used to accommodate the maternity hospital. The congestion in maternity hospitals is not confined to Dublin; it is a serious problem in other parts of the country. Growing demand on maternity services is a serious problem in my constituency.

I support Deputy Neville's comments on mental health services. Nobody wishes to comment on the case in the news yesterday but the policy document, A Vision for Change, made a number of recommendations on mental health services. One of these was that specific funding be allocated to those services each year. The allocation is €29 million for next year but that sum does not appear to be included in the health Estimates. There has been strong lobbying for a number of years to bring to public attention the needs of our mental health service, which has been the Cinderella of the health service for a long time.

Patients often present to hospital accident and emergency units with serious mental health problems. They live in the community and might have acute mental health issues that must be addressed. There should be liaison in the public accident and emergency services so a person who presents with a mental health problem is not sent away and advised to attend a clinic in the community a few weeks hence. All Members are aware of cases in their constituencies where somebody in acute mental distress has presented at an accident and emergency department but was left with nowhere to go. In some cases, the result has been suicide and in others, tragically, it has been violence. This is an urgent issue which must be addressed.

Another issue is child and adolescent psychological services, in particular the need for inpatient services. In my constituency there are no beds for child and adolescent psychological cases. An adolescent with a mental health problem must be accommodated in an adult ward.

There are appalling lapses and gaps in the public health service that must be addressed. I am concerned that funding has been so curtailed or tied to maintaining current services that we are not developing other services that are required. I appreciate that the HSE must watch its budget but I would prefer it to cutback its budget in certain areas where money is being wasted and ensure that money which was promised for other important areas is made available.

The Labour Party does not oppose most of the content of the Bill but it cannot support the elements relating to co-location. This is legislative sleight of hand on the part of the Government, which is demanding that the Dáil enact emergency legislation to close a loophole but is bundling urgent and non-controversial matters with those that are not urgent but intensely politically contentious. We propose the amendment for that reason.

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