Olivia Mitchell (Dublin South, Fine Gael)

Like my colleagues, I have no problem in supporting the legislation which is necessary to copperfasten and legitimise the status of the existing bodies, but I question the other measures contained in the legislation. I also question the reason this issue is suddenly so urgent that we must put emergency legislation through the Dáil during Christmas week. The reality is that the urgency comes in the context of co-location and the Minister's anxiety to put the legitimacy of co-located hospitals beyond doubt and, crucially, beyond challenge. It is not the status of the 19 bodies concerned that is urgent but the two bodies in question, St. James's Hospital and Beaumont Hospital. Those two are the only ones about which there is any urgency from the Government's point of view.

The reason I am here at 8.40 p.m. during Christmas week is that I strongly believe that co-location is a big mistake. It is not the direction in which we should take Irish medicine. While we will pass this legislation in haste, unfortunately we will repent at leisure because we will regret the path on which we are taking medicine by this move.

Co-location is very much the Minister's baby and she genuinely believes it is a desirable innovation, but I could not more strongly state that I believe she is wholly wrong in this. It is a far more fundamental change than merely one that will give us hospital beds in a hurry, and that is the ostensible reason for opting for co-location.

The mistake we are making in taking the allocation of private beds out of public hospitals will fundamentally change medicine in Ireland for the worst. It is not what the Minister intended, but it is what will happen. The reason given for co-location is that the private sector can provide quicker than the public sector, which I do not doubt for one minute. That is true, but it is not a reason to opt for co-location. The issue, essentially, is a planning problem. We do not have to go to the extreme of taking the allocation of private beds out of public hospitals and depriving them of the stream of money they have taken from the health insurers, primarily the VHI, over the years. The cutting of that funding on which the hospitals have depended will have a fundamental effect on and will reduce the standards in public hospitals. It will cut the income doctors have received and that has helped to keep the best doctors for public patients in public hospitals, as a result of the mix of public and private medicine.

That system worked very well for us, hard as it is believe, up to the time when the supply of beds fell behind the demand for them, in other words, when demand outstripped supply. That happened as a result of the cutbacks in the 1980s and 1990s, subsequently followed by the growth in population. It was not the public-private mix that was wrong but that rationing had to take place when supply was outstripped by demand. That was the problem.

Unlike others who oppose co-location because they oppose private medicine, I do not oppose it for that reason. I believe there should be more private medicine and that it is a good idea to buy services for public patients. People who buy health insurance should be allowed to continue to do so. There is better value and consumer focus in private medicine and our public hospitals should not be deprived of that incentive to higher standards and better doctors. They will suffer catastrophically from the withdrawal of private medicine. For that reason I believe co-location is a big mistake. The Minister should think long and hard before she takes us down a road that we will bitterly regret in the future.

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