Tom Hayes (Tipperary South, Fine Gael)

What is at issue tonight affects not only the people of Nenagh and Ennis but all people living in rural Ireland, no matter from what part of the country they come. In recent years we have been obsessed with the notion that making things bigger automatically means better services. I will draw a comparison which might sound funny. Those of us from rural constituencies will remember the amalgamation of creameries many years ago, and how this was to change the face of rural Ireland. We now see the difficulties the dairy industry is in. In my own constituency of south Tipperary, Mullinahone Co-op, a small unit that was left there on its own, is now probably more efficient than any other unit. I am making that comparison because we are obsessed, in every facet of life, with making things bigger and amalgamating them.

South Tipperary has suffered one of the most divisive events to occur in the health system, the amalgamation of services at Cashel and Clonmel. The debate went on for about 40 years and divided the people and the towns. Ten years ago the two hospitals were amalgamated and the surgical hospital was taken to Clonmel. A great plan was put in place. Now, ten years on, it is proposed to move some of the services to Waterford, including the maternity service. Last Monday the Oireachtas Members for south Tipperary were briefed and told the Teamwork report would be shortly moving south. What is happening in the mid-west region will happen to us. There will be more amalgamations in Wexford, Kilkenny, Waterford and south Tipperary. The people of north Tipperary and Clare are right to stand up and fight every inch of the way. This amalgamation will not bring more efficiencies to the health service. That is our experience. I ask every public representative on all sides of the House to consider what has happened in south Tipperary. It could have been a good experience but, alas, I do not believe it was. People in Cashel are waiting for services, while some have been put in place. The staff contact me on a regular basis about all the things that have not yet been provided. There is a fear in north Tipperary and Clare that the improvements that have been promised will not occur. There is no confidence that these changes will bring about an improved service. That is what is wrong. To say people will get better services looks good on paper and sounds better. However, the reality is that services have not improved over the years. When we had small hospitals in every town around the country there were better services, and people supported that. That is why I say the Teamwork reports, when their recommendations are put in place, do not necessarily result in a better service.

See this speech in context