Fergus O'Dowd (Louth, Fine Gael)

I will share time with Deputy Neville and Deputy Reilly. Team work implies that everybody works together; it involves people working to a particular and agreed objective. Most of all, it involves consent, effort and everybody rowing in the same direction, like a rowing boat team in a race, towards the target of better health for everybody. I can offer to the people of the mid-west my experience of the so-called Teamwork report for the north east. The lessons that have been learned there have obviously not been taken on board by the Government.

There is no team work. It is health administration by diktat by people who are not nameless but who are certainly not publicly accountable. There is no transparency about their actions and no knowledge about what is happening. They decide and dictate. There is total chaos in the north east. The so-called team work principle of people working together does not apply there. The Minister for Health and Children, her Department and the HSE have refused to insist on the basic tenet of team work, a principle the Minister enunciated, that no service will be closed down until a better one is in place for the people.

It is quite reasonable and clear that if one has a serious illness that requires specialist knowledge and technology to treat it, one will travel to the ends of the earth to get it. In the north east the smaller hospitals are being closed down, with the services being put into two hospitals, one in Drogheda and one in Cavan. Every day this week in Drogheda there was an average of 20 patients on trolleys. People spend their nights not in hospital beds or rooms but in offices. It is an appalling situation in which people are treated very badly. This is happening while there are vacant beds in other hospitals which could accommodate those patients. They are not being sent there because the HSE Teamwork plan is to close them down. However, it is not putting the replacement services in place.

All the general practitioners, nurses and medical staff in the region have said that the transformation team is not working. I understand four directors appointed by the HSE to assist the Teamwork approach have resigned because they could not fulfil their obligations and provide the services that are so badly needed. Clearly, that is also happening in Clare and north Tipperary. The pressure will be put on Limerick Regional Hospital and it will be unable to cope.

The bottom line is that the Teamwork report is all about stress. It is about doctors complaining. A total of 41 general practitioners in Cavan and Monaghan have written recently to the Minister, Deputy Harney, about this issue. They clearly state that it cannot and will not work under the current arrangements because the Minister is failing to put in place a better, more effective and efficient service to deliver services to patients in the region. The two major hospitals are overcrowded, which is a cause for concern. There is concern about the number of anaesthetists on duty. There have been very serious errors in areas like radiology where people have died as a result of misdiagnosis, and the Minister does not want that to happen in Nenagh, Clare or Limerick.

The key is for the Minister to get her act together. If she is proceeding with a Teamwork report, it should only happen when there is team work, when everybody is on board — the nurses, the doctors, the consultants. The problem is that the Minister is working in the dark, is operating by diktat and working in a way in which the consultants are not involved. As a result, there is fiasco and chaos reigning in the hospitals in the north east because of Teamwork.

Our colleagues from the mid-west are clear about their concerns today. It will not get better. It will get worse because the Minister is not providing the investment before she moves the people to the hospitals. Is it any wonder they would be up in arms, worried and concerned?

If the Government wants to be successful, a good Minister for Health and Children will ensure that everybody buys into the process. In that regard a step by step process is better for everybody. One cannot close down services until new services are in place.

I would warn the HSE in the mid-west to look and examine what is happening in the north east, and to fully examine and understand the situation there. If the HSE would have sight of the letters of which the Minister has sight from all of the consultants, the general practitioners, the specialists in the region and the ordinary people, it would understand what a mess the Minister is making of the health service and how upset and how disadvantaged the people in mid-Munster or Clare, in north Tipperary and in Limerick will be as a result of the Minister's appalling and shameful operation of the HSE. A better name for it probably might be the "Hide-and-Seek Executive", especially when one considers the cases where one cannot make contact with the relevant officials. It is the health secrets executive. The Minister cannot get at the truth, cannot get accountability and transparency, and cannot get at the facts. She can never influence those decisions. That is why the Minister has all those people up in arms with her.

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