James Reilly (Dublin North, Fine Gael)

I welcome the Minister of State at the Department of Health and Children, Deputy Devins, and express my disappointment that the Minister, Deputy Harney, cannot be present. This is a very important debate and I find it extraordinary that she is not in the country when we are discussing health services that can be a matter of life or death for many citizens, particularly young people with cystic fibrosis.

In recent weeks, we have all heard young cystic fibrosis sufferers bravely describe on national radio and in the national papers the deficiencies in services for cystic fibrosis patients and the unacceptable conditions they have been exposed to in our hospitals. It is appalling that these brave young people have to resort to the national airwaves and newspapers to highlight the difficulties and dangers they face in the hope that they may force the changes that will give them a fighting chance — this is all they seek — to achieve the life expectancy of their fellow sufferers in Northern Ireland, Britain and the rest of Europe. I commend Joe Duffy of "Liveline" for highlighting this matter and giving it airtime.

A similar media furore ensued, almost three years ago to the day, when the shocking findings of the Pollock report where published. Dr. Pollock found that people with cystic fibrosis were being treated in facilities that were understaffed and dangerous. How little has changed. In response to the Pollock report, the Health Service Executive established a multidisciplinary working group to report on cystic fibrosis services nationally. Although the group has concluded its work, its recommendations have not been published to date, cystic fibrosis services remain seriously understaffed and patients face the same difficulties in accessing safe services that they faced some years ago.

The facts remain that more than 83% of sufferers have not seen any significant improvement in the treatment levels of adults with cystic fibrosis since the Pollock report was published. There are no dedicated adult or paediatric cystic fibrosis beds in the country and every time a patient waits in an accident and emergency unit or is treated in an open ward, he or she risks contracting a potentially life-threatening infection. Cystic fibrosis patients rely on the health service to keep their condition under control. The lack of isolation facilities, both for outpatients and inpatients, poses a most serious risk of cross-infection, leaving cystic fibrosis patients vulnerable to contracting MRSA and other potentially life-threatening infections. The Minister of State knows this well because he is a doctor.

Patients are getting sicker in hospital and are spending longer in recovery because they are being treated in dangerous facilities. This is why their life expectancy is ten years less than in Northern Ireland and Great Britain. It is disappointing that so little has changed three years after the publication of the Pollock report. The only way to improve mortality statistics for people with cystic fibrosis is to protect them from cross-infection by treating them in isolation facilities that minimise cross-infection from other patients.

Under significant pressure, the HSE has reluctantly decided to fast-track the development of St. Mark's Ward in St. Vincent's Hospital to provide six single rooms within the next ten to 18 weeks and an additional eight single rooms by the end of the summer, resulting in a total of 14 — that is if we can believe its promises. It has broken so many in the past. Although the promised beds are welcome, they are insufficient, considering there are currently 18 cystic fibrosis inpatients in St. Vincent's Hospital and ten on the waiting list. This requires a total of 28 rooms. We are deficient before we even begin.

I am sure the Minister can understand our scepticism when we are offered promises and assurances about the delivery of projects, particularly within the health service. In 2002, we were promised an additional 3,000 hospital beds but we still do not have them. Instead, there is now talk of pulling 4,000 beds out of the system. We were promised a permanent end to waiting lists in our hospitals by 2004 but this never happened. In 2002, we were promised that full medical card eligibility would be extended to 200,000 people but this never happened either. Can the Minister or the Minister of State, on her behalf, give an unequivocal guarantee to people with cystic fibrosis that six single rooms will be available for use by the end of April 2008 and that an additional eight rooms will be delivered by the end of August 2008? Will these beds be ring-fenced for cystic fibrosis patients or will they be available to all respiratory patients? I doubt that the Minister, who is not present, will make this commitment, considering that she told the House last week that she is terrified of giving deadlines.

Considering that 20% of the 2006 budgetary allocation and all of the 2007 allocation remain unspent, one must ask when the recruitment process for specialist staff will be completed. It was stated recently that 80% of the appointments have been made or advertised. Talk about weasel words and doublespeak.

With over 1,100 cystic fibrosis patients, Ireland has the highest incidence of cystic fibrosis in the world. It is unacceptable that the average life expectancy for a cystic fibrosis patient in Ireland is the lowest in western Europe and that people with cystic fibrosis in Northern Ireland can expect to live ten years longer than those living in the Republic. Northern Ireland is a mere 40 minutes up the road. These appalling statistics are a damning indictment of our health service.

It is inexcusable that we have no specialist unit, that money allocated in 2006 and 2007 remains unspent, that proper home-care support to prevent hospitalisation is not available and that we have not made any high-frequency oscillating vests available to cystic fibrosis sufferers. These vests are not suitable for all cystic fibrosis sufferers but we should surely have an assessment system in operation to make them available to those they would help. We could do this immediately and we do not need to erect buildings to do so. Some people in Kilkenny have availed of the vests. It is inexcusable that the HSE working group report remains unpublished, that we have no indication how neonatal screening will be introduced or the timescale and, most important, that we have no isolation beds and en suite facilities for cystic fibrosis sufferers.

It is not just disappointing that services for cystic fibrosis patients are far below internationally acceptable standards and that patients must wait until 2011 for the new single-room block at St. Vincent's Hospital. One should forget about 2010 because the contracts are not being issued until the end of the year, as Deputy Shatter pointed out at the end of last week. This means the building will not be finished until late 2010 and will not be commissioned until well into 2011. It is disgraceful that we continue to imperil the lives of cystic fibrosis sufferers due to lack of political will to implement the clearly defined changes I have mentioned. The Department of Health and Children is already aware of a company in Tyrone that will build a modular unit in four months rather than two years and whose services have already been availed of in the Mater, Beaumont and Temple Street hospitals. The technology exists and all that is required is the political will.

I want to touch on mental health services and the lack of funding in this regard. My colleague, Deputy Neville, will also address this matter. It is totally unacceptable that funding allocated for the implementation of the recommendations of A Vision for Change is being diverted to other areas. The Irish Mental Health Coalition recently revealed that almost half of the €50 million allocated for the implementation of A Vision for Change in 2006 and 2007 was hived off to meet current spending deficits in mental health services. This is a downright betrayal of patients and a U-turn on the Government's own policy. In this regard, we have heard more weasel words.

While speaking on "Prime Time" some weeks ago, the Minister of State, Deputy Devins, was unable to answer how much of the €50 million was actually spent on mental health services. Does this sound like a Minister of State who is engaged and in control of his brief? Is this what we should expect from a Minister of State who has primary responsibility in this area? The Government cannot pretend that it did not know the funding allocated over the past two years for the development of mental health services was not delivered. Blaming the Health Service Executive for this is just not an option.

In January, the Irish Psychiatric Association published a report entitled Lie of the Land which revealed that money realised from the sale of assets in the mental health service was not being ring-fenced for reinvestment in the psychiatric services. Last week, Deputy Devins stated he had asked the Health Service Executive to prepare a report on The Lie of the Land in so far as it relates to the disposal of assets over the past two years. Why only the past two years?

In 1984, a document entitled Planning for the Future, a mental health document——

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