Seán Fleming (Laois-Offaly, Fianna Fail)

I would like to move on to the topic in question. We are here because of the difficulties that arose in the Midland Regional Hospital in Portlaoise and the delayed diagnosis for nine patients. We should never lose sight of the fact that every debate on the health services is about patients, not politicians. The delayed diagnosis has caused serious health problems for those involved and the Oireachtas should do everything in its power to ensure those people and their families are personally supported in every way possible, both medically and emotionally.

We must put our hands up. This is no different from what happened with Dr. Michael Neary in Our Lady of Lourdes Hospital, Drogheda. These people were appallingly treated by the health services of this country. We can blame the Government, the former health boards, the HSE or whoever, but ultimate political responsibility stops here with the Minister for Health and Children, Deputy Harney and I admire her. I have heard and seen her on television in recent days accepting political responsibility for the health services. People ask where the buck stops and she firmly says, and has said in recent times, the buck stops on her desk. That is as it should be and we see it here today. At no stage does she try to shirk her responsibilities. If there is a request from the patients or families I hope she would meet them and if anything can be done regarding compensation, I hope that will be done for the victims concerned. The health service's duty of care was breached and the people suffered ill health effects as a result.

When it is all over and we have our different reports we can go through the different aspects of them at length, but reports count for nothing if we do not learn the lessons. We are learning the lessons and the Minister and the HSE are learning the lessons. That is the most important matter. We had a brief resumé of how this came about. Former Minister for Health, Deputy Noonan, published a national cancer strategy in 1996. That proposed a specialist cancer centre in the midland region. The then Midland Health Board sought approval from the Department of Health to appoint three additional consultants for that centre. Those posts were never filled. It was held up on Comhairle na nOspidéal and different situations like that. In hindsight we all know the reform of the health delivery service in Ireland was long overdue. I support one unified structure for the whole country. People in Sligo and Portlaoise are entitled to the same treatment as the people in Dublin. I do not want to be pigeonholed in a unit in the midlands nor do I want others to be pigeonholed in a unit in the west of Ireland when there is Rolls Royce treatment available in Dublin. I support one structure for this. Some Deputies talked about going back to the old system in some form, but that is mischievous and is not good for the delivery of health services. There are 4.5 million people here and one health service can give us a unified structure.

We have a new national cancer control programme under Professor Tom Keane. We have eight specialist centres and I do not want to hear the term "centre of excellence". That implies that if people are not at a centre of excellence, they get a bad service in their hospital. I do not know where these phrases come from. They are specialist centres for cancer care and are not the only centres of excellence. Every hospital should be excellent in the work it does.

There has been a fundamental change. The move away from the national cancer strategy announced in 1996 means that the 12 regional centres have now been reduced to eight. Places like the midlands will not have a centre, but the people of the midlands will be better served under the new arrangements. If we have to travel to Dublin we will do so. The issue is not the convenience of visitors, but the delivery of the best care for the patient who needs treatment.

Many people played politics with Portlaoise over the years. I will be generous and say that most people acted in good faith. They might have been misguided, but I hope they were not malicious in what they were doing. People are playing politics with health in this House today. I thought that by taking the politics away from the health boards and establishing the HSE, we would take the party-political bickering out of the system, but we seem to be getting that in the House today. That is a retrograde step. We should talk about health.

I have listened to Professor Brendan Drumm at the Committee of Public Accounts on several occasions and I have the height of regard for him. The man has immense knowledge and ability. It is a mammoth task to manage 120,000 people. Nobody will ever get it 100% right, but he has the authority. However, the Minister, the Department of Health and Children and the Secretary General are possibly one step removed from the delivery of services, as Professor Drumm is the Accounting Officer. It would be better if the Accounting Officer was directly in the Department reporting to the Minister, rather than reporting to a board which in turn reports to her Department. That puts an extra layer on things and diminishes the level of good communication. We have seen on occasion that there has not been good communication from the HSE, but that body must then communicate to the Department officials, who in turn report to the Minister. I feel sorry for her sometimes because she does not have all the information in front of her when most of the documentation lies with the HSE. We need to streamline communication from the chief executive of the HSE directly to the Minister, as she is politically accountable. She is happy and courageous enough to be accountable and she is to be supported in that.

The main job of this House is to recognise the mistakes made, look after the patients as best we can, learn the lessons and move on to the new cancer control programme under Professor Keane. Through Professor Drumm and the Minister, we should try to deliver the best health service possible from now on.

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