Enda Kenny (Mayo, Fine Gael)

I refer to the evident mess in Portlaoise, in respect of which the three reports provide a damning indictment of the management capacity. It shows clearly that the bureaucratic monster set up by the Government is anonymous and responsible to no one. It answers to no one because no one is in charge of it. This is the reason the Taoiseach claims this is a systemic weakness. He should tell that to the patients who are waiting for 18 months or two years for check-ups. He should tell that to any of his Deputies, whose offices could be papered with letters from people whose loved ones and family have had experiences in which the HSE has not delivered in their interests. I again ask the Taoiseach whether he is prepared to express public confidence in the management capacity of this bloated, bureaucratic administrative monster that patently has failed as one of the twin pillars of the Minister for Health and Children, Deputy Mary Harney.

One does not need a PhD or to be a Harvard scientist to know what should be done with the HSE. I share the Taoiseach's view that clear, decisive and responsible decisions should be taken in this regard. I wish to suggest five proposals to the Taoiseach. First, the HSE must clearly put the patient at the centre of the system, which patently is not the case at present. Second, every employee must know his or her duties, responsibilities and remit. Third, decision-making in respect of services must be devolved to regional and local level to the greatest possible extent. Fourth, the bloated bureaucracy at HSE headquarters must be broken up. Fifth, accountability to the Oireachtas and to the elected Members of Dáil Éireann of all parties and none must be clear and must be dramatically improved. Were the Taoiseach to implement these five proposals, I would congratulate him.

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