James Reilly (Dublin North, Fine Gael)

No, but the Minister's Government is responsible for the misery patients suffer under the Health Service Executive and that we must suffer in terms of the finances of the country.

Like Deputy O'Sullivan, I am no clearer now on the position and I want to ask the Minister a specific question. It is reported in The Irish Times that there will be four or possibly eight new regional management structures. Is the Minister telling the House there will be new management structures regionally or there will not because it is not clear from what she has said? It said also that the existing services would be broken up and existing management structures streamlined. If that is not true, I would like the Minister to clearly indicate that.

The Minister mentioned redundancies, something we have all looked for, but it is clear that should have been done before the HSE was formed. The Minister coming into the House and talking about more changes in anticipation of redundancies down the road is a recurring theme because whether it is cancer services she referred to or other services, removing existing services today on a promise of something wonderful to come tomorrow is wrong. We now have another plan that promises to deliver something further down the line. The Minister's promises have not been well kept. She promised there would not be any health cuts, but there were, and she promised they would not hurt patients, but they did.

Some time ago I asked the four questions I felt had to be answerable by management in the HSE. They were not answerable in either the Fitzgerald report or the Doherty report. Can the Minister give us a guarantee as a result of this measure that in the future management will be able to say who made the decision, why it was made, what it cost and, most important, how it impacted on patient care because none of this matters a whit if that is not the net result?

Furthermore, anybody in the HSE should be able to say what is their job, who they report to and who reports to them. If, as a result of these changes, the Minister can say those questions can be answered she will have done a good day's work but, unfortunately, I do not believe from what the Minster has said that that will be the case.

Another recurring theme of the Government is that the Minister intends to promote the communications director to that of national director. If that director was to control internal communication, which is a major deficit within the HSE, that might be something we could applaud the Minister for, but I have a sneaking suspicion, having listened to her outline all the wonderful work going on in the HSE that must be communicated to the wider public, that we are back to another Transport 21 situation where €15 million was spent on explaining to people why Transport 21 is not being delivered while telling them about all the great measures that will be taken.

The same is being done with the HSE. It seems to be a case of more money spent with very little gain for the patient. That is the major issue. How will patients benefit from this measure? Rather than the philosophical, patient centred wonderful words we heard from the Minister, we should see some action because we have seen no action that has resulted in true improvements for patients.

The Minister has told us in the past, as has the chief executive of the HSE, that services have improved, the figures are much better etc., yet independent figures taken from the Irish Association for Emergency Medicine show that in Beaumont Hospital the figures for the number of people lying on trolleys for over 12 hours waiting for a bed in April of last year were in the region of 380. Last April the figure was 904. It is the same in Galway. The figure was 185 in April last year while this year in April the figure was 444. That is one of the regions that will be a centre of excellence for cancer services, which are being delivered to an excellent standard currently in Mayo and Sligo, but the Minister wants to remove them and locate them in Galway where there is no adequate parking, there is a €4.6 million ICU suite that cannot be used because there is no staff and in April or May they were already €4.6 million over their budget. I do not know what the figure is now. There are all the signs of overcrowding, with the accident and emergency figures and MRSA.

I believe the Minister has taken notes of the main question but I want to ask one other question.

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