James Reilly (Dublin North, Fine Gael)

I move amendment No. 2:

To delete all words after "Dáil Éireann" and substitute the following:

"—expresses its serious concern at the findings of recent reports into breast cancer services at the Midlands Hospital Portlaoise;

regrets the deep distress caused by these failures to many patients and women in the midlands;

concludes that the reports demonstrate serious failures in the management of the HSE and in the delivery of essential health services;

notes that these failures arise directly from decisions made by the current Minister for Health and Children, Mary Harney, T.D. and her predecessor, the former Minister for Health and Children Micheál Martin, T.D.;

is alarmed that the Minister for Health and Children Mary Harney and all other members of the Government continue to express confidence in the current structures and management of the HSE;

calls on the Government to reform the HSE so that within 3 months:

the service puts the patient at the centre of all its activities;

every HSE employee has total clarity about their roles and responsibilities;

decision making on services is devolved to regional and local level to the greatest extent possible;

the bureaucracy at HSE headquarters is reduced; and

HSE accountability to the Oireachtas is dramatically improved."

The Minister is correct in that this debate concerns women and patients, particularly the women of Portlaoise and their families who have been treated so badly by our health service and have suffered so appallingly. This debate takes place in an effort to bring political accountability to the House for the defective health systems that failed us and over which the Minister presided. While the errors were clinical, they occurred because the system did not put in place appropriately qualified personnel. As the Minister stated, the radiologist appointed was not one with a special interest in mammography and no specialist pathologist was put in place.

I note in the Minister's speech the emphasis on centres closing rather than centres of excellence developing. I am sure people will take a message from this. A deficit of approximately €360 million in the HSE and a struggle to perform with today's services while maintaining last year's do not augur well. I would like to believe the Minister, but the record prevents that. Like her, we want to ensure that every effort is made to prevent such a catastrophe from recurring so that no patient or family will need to experience a similar situation.

Discussing the establishment of the HSE in November 2004, the Minister stated: "It is a once-in-a-generation event... our generation's chance to put patients first in the design of the management of health services". She continued: "We badly need clarity of roles and accountability — political responsibility for the Minister and management responsibility for the management... that will make a real difference to the quality of health services provided for our people". Does this sound familiar? If anything, the reports published last week prove that patients are not put first. Despite the Minister's lip-service to the contrary, the HSE management is anything but effective. The ethos of administration, as pointed out by Professor Niamh Brennan in her report, is clear, but there is no management ethos and people are still unclear about their roles and responsibilities three years since the HSE's establishment. This is incredible. Any CEO or head of such an organisation would have been shown the door, as stated by senior businessmen. If political accountability is to mean anything, the Minister must accept responsibility for the failures of her creation, the crass, uncaring way these women were treated and for her inaction and that of her Department.

The Minister referred to Dr. Naughton's letter but, until last week, the Minister denied its existence and her Department knew nothing about it. However, it was sent to the Minister's predecessor in 2002. In it, Dr. Naughton highlighted his serious concerns about cancer services in Portlaoise and brought to the attention of the then Minister, Deputy Martin, the lack of progress made in cancer services in the region since Portlaoise became a designated centre for cancer care in the midlands under the Government's watch in 2001 and the publication of the O'Higgins recommendations on symptomatic breast disease in 2000. The Minister and her colleague presided over this issue. Portlaoise was a designated centre of excellence, but it was not funded appropriately. Notwithstanding the inability to find the letter and the implication that it never reached the Department, it is interesting that action was taken on it. This is extraordinary logic.

See this speech in context