Brian Cowen (Laois-Offaly, Fianna Fail)

Regarding the question of reports being commissioned by Departments, it cannot be suggested that, within our public service or within each Department, there is the total level of expertise necessary to give full and frank advice on every aspect of what is a very complex service delivery system. Even taking the number mentioned, that of 120 reports in the Department of Health and Children, some 98% of the problems, dossiers and files that are dealt with by the Department where decisions are taken are done without any reference to a report.

If one is trying to develop a public policy position or to change a policy in order for it to gain greater acceptance among various stakeholders in, for example, the pharmacy area, the Irish Medicines Board area or the question of how one can improve the delivery of disability services, one would often bring in various stakeholders and ask some independent person to work and collaborate with them, listen to the various points of view and come forward with a set of proposals arising from that process. These things are not necessarily expensive.

Taking the report in question as an example, there was a need to get someone from outside the country to do a peer review to determine how well the Irish public service was doing compared to other public services, the ways in which it was different, whether it was ahead of or behind others and whether any best practice models in other countries could be applied to the Irish public service. The OECD, which has done a lot of work in this area and in public administration and policy formulation generally, was the obvious group to take on the task. It took whatever time was necessary and did it in a very comprehensive fashion, as I have outlined in my reply.

If doing a report is a precursor to pulling a range of diverse opinions behind a means forward to deal with some of these issues, on a cost-benefit analysis it is very much the right thing to do. If it charts a way forward, as this task force now does by pushing the buttons in respect of all areas to determine how to bring about public service reform, it is a far more cost effective way of doing it than allowing each sector to go at its own pace and to do its own thing, some successfully and others not so much because there is no overall systemic response that would bring about a coherent outcome.

Sometimes, this idea that one can only have an effective Government if no one reports to it about some issue is a simplified and populist message. I am sure that it goes down well with certain elements, but it is not necessarily a very accurate assessment of how modern governance systems can work in a modern democracy.

Regarding the National Treatment Purchase Fund, I do not know the specific case to which Deputy Kenny referred or how accurate he was. However, as a mechanism for increasing throughput in the health service and identifying people who have been awaiting treatments, its contribution to improving waiting times has been a great success. When I served as Minister for Health and Children, waiting times were between two to five years whereas they are now between two to five months. Last year alone, waiting times were reduced in 60% of the categories to which such waiting times apply. Improvements continue to be made.

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