James Reilly (Dublin North, Fine Gael)

Like my colleague, Deputy Shatter, I will raise the Minister's attitude to the legislation. For the Government to continue to behave as it has done with this Bill would be to tell the people that it will, in future, legislate in the dark and, in the event of legislation being urgent, as the Minister argued regarding this Bill, Deputies will not be given access to the relevant advice issued by the Attorney General. Such an approach is not a runner because democracy cannot function in this fashion. Ministers cannot inform Deputies for the next three, four or five years that having received the advice of the Attorney General on a specific issue, the House must act urgently to pass legislation without properly considering or debating the issues.

Why is 52% of the population insured? It is not because individuals choose to have health insurance but because they feel compelled to have it. They do not believe the public health service will deliver for them in a timely fashion. People are happy with the care they receive if they can access a service but the problem is that waiting lists prevent access to the health service. On five occasions this year, I have received letters from the ear, nose and throat department of one of our great health care facilities, Beaumont Hospital, stating that the hospital cannot offer an appointment within a year and suggesting the patient try a different service. No attempt was made to arrange an appointment for another time.

I remind Deputy Woods, for whom I also have a great deal of time, that since being returned to power in 1987, Fianna Fáil has held office for 18 of the 20 intervening years. Soon after I joined the Eastern Health Board in 1987 or 1988, the board discussed the establishment of a new psychiatric service in Beaumont Hospital to replace the services provided in St. Ita's Hospital, Portrane, which was considered an inappropriate location as it was housed in a 100 year old building on a relatively isolated peninsula that was difficult to access by public transport. In 2007, 20 years later, this service has still not been completed. It is clear that the problem in this area lies not with Fine Gael but with those who have been in a position to resource and fund services but have failed to do so.

Deputy Shatter referred to neurosurgery. Neurologists are in terribly short supply, with people waiting years to see a specialist. Many people with Parkinson's disease and other illnesses are in dire circumstances, with some of those living at home and facing the possibility of recurring brain tumours unable to access hospital services because beds are not available. Consultants are being asked to choose between admitting individuals who are unconscious and persons who, while conscious, have a condition which may erupt at any moment. That is no way to run a health service.

Where will serious trauma cases go in co-located hospitals? The Minister and I both know that road traffic accident victims suffering from serious complications will be admitted to the accident and emergency department of the public hospital, which will incur the full expense of treating the victim. Once the patient's condition has been stabilised, however, he or she will be transferred to the private hospital.

I do not understand the difficulty with having private beds in public hospitals. At least in those circumstances, training is available to junior hospital doctors and all the facilities are in one place and can be shared. It does not make sense to establish separate co-located hospitals on grounds which will no longer be available to the public hospital should it require them at a later date. This policy will result in cherry-picking of easier procedures which can be performed without any great infrastructural needs, leaving the more costly, difficult procedures to the public health service.

If the National Treatment Purchase Fund ceases to operate, how will the co-located private hospitals survive? Given that the VHI does not appear to believe these hospitals have a place, how will the Minister ensure an ongoing supply of prospective clients for these private hospitals?

Co-location is another case of the Minister distancing herself from her responsibility for health care by delegating the running of hospitals to the private sector. We have seen the problems this hands-off approach can cause. The lack of a proper inspectorate for private and public hospitals has resulted in members of the public, specifically women, having to endure the problems we have experienced in Barrington's Hospital, the Midlands Regional Hospital Portlaoise and other facilities. I repeat a question the Minister failed to answer. How many co-located private hospitals will be not-for-profit facilities?

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