Liz McManus (Wicklow, Labour)

I congratulate the Ceann Comhairle on his appointment. I am sure he will do a great job.

I welcome this Bill and compliment Deputy James Reilly on his initiative. The Minister's response is also welcome. Her acceptance in principle of the Bill makes sense. Many people would be surprised to learn that there is no legal requirement for a practising medical practitioner to have insurance.

This statutory measure will protect patients and doctors. I hope it will also open up the route towards the regulation of private clinics, which currently are not regulated. The growth in cosmetic surgery was a feature of the Celtic tiger years and private clinics have provided services with doctors flying in from Britain, carrying out procedures and then flying out again. Whether the private clinic delivers cosmetic surgery or IVF there is an obvious need to set standards and ensure their robust enforcement.

It is not, however, the private clinic that is causing controversy at the moment. It is the public health service and how it is managed. The public is outraged at the latest news of the lavish €70,000 bonus sanctioned for the CEO of the Health Service Executive. The Minister for Health and Children has simply washed her hands of the issue but it will not go away. Let us look at the facts. Since he took up the post of CEO, Professors Drumm has received €180,000 in bonuses. This year alone his total salary package is worth more than €500,000, a staggering figure. While the HSE sanctions this reward to its CEO, it is setting about making cutbacks of €1.2 billion in the coming year.

The argument being put is that this bonus relates to 2007 and therefore is a contractual obligation, but the question still has to be asked: for what exactly is the bonus being given? We are told by the chairman of the HSE board that there is a process of evaluation in determining the level of bonus. It would be helpful to know the criteria used in that process. Are they related to patient outcomes, improved patient care, higher standards, quality assurance or speed of access? If they are, and they should be, let us look at the record. Susie Long died in 2007. She was a young woman with cancer and she died because the HSE did not provide her with the care she needed in time. Women were misdiagnosed at Portlaoise hospital in 2007. Again, the HSE failed to protect and care for very sick women. In the year in question, 2007, the HSE was not even capable of keeping within its budget. A supplementary estimate of €244 million was drawn up because of a failure of management that drew criticism from the then Minister for Finance, Deputy Brian Cowen. He said he was not satisfied that the HSE was giving sufficient priority to tackling the causes of its budgetary difficulties. For the failure to manage the accounts in 2007 a reward of €70,000 is now being given to the CEO responsible. Is it any wonder the public is offended? It appears to be all about responsibility. The proposals in this Bill will ensure doctors cannot walk away from responsibility when something goes wrong. All of us understand that doctors are not infallible. Allowance must be made for the unforeseen, the unplanned or the human error, quite apart from the negligent.

Patients deserve protection from medical negligence but also from political incompetence. When the Minister for Health and Children, Deputy Harney, proceeded in her bull-headed fashion, to establish the HSE without giving it the time needed to ensure proper management structures, I warned her in this House that she would create a monster bureaucracy. The rush to get the HSE up and running by a politically-driven deadline of 1 January 2005 gave us a cobbled together structure with weak foundations constructed by the Minister, from which she then walked away. It has been tottering ever since. Never in my wildest dreams did I imagine just how bad the situation could get.

Currently, three years after the Minister declared a state of national emergency, the accident and emergency crisis continues. According to INO figures there are almost 300 patients on trolleys around the country. Perhaps those patients should have recourse to making an insurance claim for the distress caused. There were 9,000 cancelled operations in the first half of this year, a 27% increase on last year. Perhaps those patients should be able to claim. This year there has been a 70% increase in delayed discharges. What about them? It is the powerlessness of patients that is so worrying and to provide patient power would require a fundamental transformation of the health service. However, that is a debate for another day.

This Bill is a simple measure to amend and extend the Medical Practitioners Act 2007. It should not be necessary for an Opposition Deputy to introduce this legislation yet it was the Fine Gael party that published the legislation. That is to Fine Gael's credit but it also raises questions about the role of the Department of Health and Children. The Minister, Deputy Harney, specifically transferred responsibility for financial management by making the HSE the Accounting Officer. Since then, the role of the Department has been always uncertain. It was to deal with policy while the HSE was to deal with implementation. It has not worked out quite like that. Surely a Department with such a reduced area of responsibility should be capable of delivering legislation to meet current needs. Insurance cover for medical practitioners is one such area that seems very obvious.

The Bill provides that the Medical Council will have the power to set the appropriate type and level of insurance to be held by different classes of practitioners. Today, the Medical Council has no such authority and, while it does require that doctors must have adequate cover, there is no system to check that doctors have cover and that it is adequate.

The Medical Practitioners (Professional Indemnity) (Amendment) Bill 2009 has the support of the Labour Party, as made clear by the spokesperson, Deputy Jan O'Sullivan. I have no doubt it will bring reassurance to both patients and doctors. We must ensure that, with mobility developing across the EU, standards for medical care applied in this country are on a par with standards in other countries. We do not have that, whether in respect of indemnity, the provision of hospital beds or the provision of services at primary care level. We could debate many issues relating to health care tonight. This is a modest Bill that deals with a specific area of medical indemnity to ensure doctors have the insurance cover to protect their patients. I welcome this measure and look forward to the Minister pursuing this Bill to bring it into law.

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