Michael D Higgins (Galway West, Labour)

I listened with great care to the debate that has taken place. A number of fundamental issues arise. Some have been touched on in the last contribution. On the degree of accountability that will be present from the allocation of a contract, moving from a tender to a contract, in the case of State laboratories and the educational preparation of technical and medical personnel, there are elaborate measures of accountability in the public system in respect of professional practice, the duties of institutions and hospitals, and preparation and validation. These are the skills and accountable mechanisms in a public system.

The alternative that the Minister described is to move outside the jurisdiction to describe a tendering process where the accountability mechanisms are neither explicit nor under the control of the State. They are under the gaze of the courts in their own jurisdiction. It is only fair to say that the favoured tenderer is not alone in drawing one court decision after another, almost all of which are in the same vein and relate to excessive testing where it was unnecessary and where the federal and individual states are involved. They relate to overpricing and over-billing, and figures of €40 million have been mentioned. That is the accountability that is offered as the alternative to the public system.

The Minister mentions that after two years there will be a review and we will move on to a new condition of contract. In a later flourish she suggests that those who get the contract may have a laboratory in this country. One may ask if this is in anticipation of the two years or if it is on condition that the contract will be renewed after two years. These questions can be dealt with reasonably.

How will the capacity to have diversity in bidding at the end of two years be established if the professionals have been prepared and the equipment purchased but it cannot be seen by RTE cameras and the students who have been prepared have not been allowed to gather experience? If one wants security in any model of health, one wants it to be integrated where one can deliver accountability and give some certainty. It is like walking out of one's house and staring at a bungalow in the distance. What provision is there for continuity for these people and the capacity to prefer an alternative bid in two years' time that would be integrated with the Irish health system?

I refer to the procurement criteria. Everyone who spoke rightly emphasised what worries every woman, the natural anxiety about speed and accuracy of diagnosis. How were the volume and turnaround requirement established as criteria? The Minister suggests 80% relates to quality and turnaround. I contradict a point of the Minister, the suggestion that several different units within the Irish system could have combined to offer an alternative to the contract that is coming from abroad. That does not fit with the facts as I know them and I am perfectly happy to illustrate them.

There is a suggestion that 20% of the tender assessment was based on cost. The Minister differs from me politically. If cost is based on very large volumes with a lower level of quality and performance and a murky level of corporate ethics, does it not worry the Minister that just for the sake of the turnaround and to meet the volumes, she is willing to put at risk the existing and potential infrastructure that might provide a fine service over which she would have full accountability? She is saying that the corporate ethic of a bidder from abroad, over which she will not have the same level of accountability, is welcome in the short term. To contrast is to sacrifice good and careful planning at the cost of an immediate knee-jerk response.

There are those who say none of this matters but it does matter. Medicine all over the world has been damaged by people who suggest that what is important is a sickness industry rather than a health policy.

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