Alan Shatter (Dublin South, Fine Gael)

My objection to co-location is that we are finally copper-fastening and institutionalising, by legislative sanction, a two-tier health service. The Minister is likely to respond by telling us that we have private beds within our public hospitals. That has been part of the tradition of this country for many years. However, we are now going to have a private hospital and a public hospital on one site, with the State making tax concessions to those who build the private hospitals. The centres of excellence will be in the private hospitals, which will have the most modern and the best facilities available.

We should be striving for an excellent public health service. The Minister should be striving to persuade people that the public health service is so good it has the capacity truly to meet its health need in a manner that does not require the general population to take out health insurance. As the numbers within the community taking out health insurance increases, the credibility of the public hospital service decreases. People take out private health insurance because they lack confidence that they will get access to essential medical care when it is needed. They lack confidence that our public hospitals will have the most modern equipment available when required. They lack confidence that they will be given the same time and consideration on occasion by health professionals within the public system that they get within the private system.

We have fantastic doctors and nurses working throughout our health service, both in the public and private sector. Within the public sector, they are under pressure. The bureaucracy involved in recruiting additional consultants across a broad range of areas is astonishing. This is not the debate to go through all the deficiencies in our health system, but we can see the number of neurologists in this country per head of population compared to other countries. The people of Beaumont Hospital are crying out for additional neurologists to meet basic needs. There are people on waiting lists to see consultants across a broad spectrum of areas, but the Minister's focus and her primary health care philosophy is to get on with the construction on public hospital sites of private hospital facilities. I think that priority is wrong and there is no indication that when this policy is implemented, we will be any better off.

We are told that up to 1,000 public hospital beds made available by the provision of private hospitals in this way, and the Minister has asked how else can she free up beds. The dysfunctional nature of the health service is creating the log-jam within the bed structure of our hospitals. There has been a debate on whether we require more acute hospital beds. I believe we do and that there are strong reasons for additional bed facilities. We need more within our public hospitals' private bed facilities, not for private patients, but to tackle the problems we have with hospital diseases, such as MRSA. We do not have the isolation facilities within our public hospitals necessary to protect the health of those who require hospital care. My mother-in-law died in Tallaght Hospital of a serious illness which was compounded by contracting MRSA within a week of entering that hospital. How many other families have had the same experience? Patients are put in wards with other patients who have MRSA. We are not doing what is done in Scandinavia, which is to isolate patients with MRSA, because we do not have within our public hospitals the single bed facilities in private rooms to do that.

If the Minister wants to free up beds in public hospitals, rather than introducing co-location which is being copper-fastened by this Bill, she should be providing additional step-down and nursing home facilities. My colleague Deputy Mitchell recently highlighted the insanity of the HSE in keeping an elderly woman in a hospital bed for many months because it would have to spend €80 per week in providing her with nursing home care, even though the ultimate net expense of keeping her in hospital was far greater. This Minister should not be focusing on co-location to free up public hospital beds, but on the provision of step-down and nursing home facilities, so that many people currently occupying acute hospital beds could get the care they require that falls short of needing acute hospital care.

I appreciate that I was not in this House between 2002 and June 2007 when the co-location policy was adopted. However, I have listened to other Deputies saying it was never discussed or debated at any great length. It has been developed outside the House and this Bill is one of the few pieces of legislation relevant to the issue on which Members have any opportunity to debate it. It is entirely wrong that we deal with this issue as an adjunct to a Bill that we are told is necessary to copper-fasten the legal foundations of the variety of bodies detailed in the schedule which have been in place for many years. The co-location issue should not be part of this, but I suspect it is the co-location issue that has made it urgent. I suspect the Attorney General's report, which we are not allowed to see and which is being kept secret, detailed difficulties in entering into co-location contracts if this Bill was not passed.

I recall many years ago the formation of the Progressive Democrats and the sense of excitement they created about a new type of politics. They stood for more transparency in politics and more democracy in a Dáil that could truly operate its legislative function committed to Governments that would be truly accountable to it. Yet this evening the Minister insists on dragooning through a Bill based on the secret advice of the Attorney General that will not be revealed, and on which we are supposed simply to rely and trust. She is doing this in the same circumstances in which the Government, based on previous advice, was responsible for the Medical Practitioners Bill 2007, which was absolutely riddled with legal deficiencies and anomalies. Why should we accept on faith that the Minister's advice requires that we deal with this urgently? What on earth happened to the remnants of the Progressive Democrats that they regard it acceptable in a parliamentary democracy to keep secret legal advice that does not place the security of the State in jeopardy on which they claim emergency legislation is based and which forms the rationale for that legislation? That is a complete and utter disgrace and a total betrayal of any remaining principles to which that party was ever committed.

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