Margaret Conlon (Cavan-Monaghan, Fianna Fail)

As TDs we must be able to see, query and demand to know where and how our constituents' and taxpayers' money is spent and why frontline services appear to be regressing rather than progressing. I have been assured and have been telling my constituents that a new regional hospital will be built and that no services will be removed from Monaghan hospital until a safer, better and more appropriate alternative is in place. I accept the Government amendment as a pledge in this regard and I will play my part in ensuring this happens. If we lift the flawed logic that the HSE is employing for the proposed reductions in services we see carts before horses everywhere. Money has been spent on a high quality treatment room and it threatened the service. Our coronary care unit which has a higher record of safety and better outcomes than most other facilities throughout the country was also threatened. We lost two casualty consultants and there has been a definite change for the worse in the level of service provided, and certainly no replacement with a safe or superior alternative.

The leaked document stated that the changes are dependent on many factors, including improved home care packages. I ask where the HSE proposes to get the €9 million it would require to put these packages in place. If Monaghan hospital is taken off call, the risks greatly increase as people have further to travel to access medical care.

It seems the HSE is making it up as it goes along and it is constantly changing the goalposts. In November I attended the official opening of a newly refurbished ward costing €5 million. I said then that the facilities were as good as could be found anywhere in Ireland and Britain. How, therefore, can the HSE justify a reduction in frontline services to the people of my constituency after opening a totally refurbished ward? I ask the HSE one simple question, what are the people of Monaghan to do when they fall ill? The HSE is now a professional master at changing the goalposts on many issues. There is never a plan B or an alternative. There seems to be a lack of logic and joined-up thinking.

I call for a wholesale audit of the HSE from the top to the bottom of the organisation at financial, managerial and human resource level. We must identify the black holes that swallow up millions of euro which should be prioritised for frontline services. We must have an independent audit of the management of taxpayers' money. We must streamline management and administrative processes. I suggest as a starting point that we need to undertake an audit to ascertain the current position and how many support staff we really need. It seems bizarre that we amalgamated so many organisations when the HSE was created and did not restructure the support staff at the same time. This is where the savings must be made, not on frontline services. There must not be any diminution of services until this audit takes place. We must call a halt to the current crazy situation where the bloated HSE is allowed to expand and become even more unwieldy. I call for a halt to that.

See this speech in context