Bernard Durkan (Kildare North, Fine Gael)

At the outset I pay tribute to the generations of medical, surgical and nursing personnel who have served in the health services over the years. They have given a great service, responding above and beyond the call of duty. I served on the Eastern Health Board many years ago and it was a good way to learn about the health services. I suggest similar experience for anyone who hopes to administer health services in the future.

We had occasion to rub shoulders and, often, to rub noses and cross swords with many of those in the higher echelons of the health service. It was to good effect, however, because it resulted in our reasoning what was best for the patient and best for the country. It did well. We lived through times before the boom when money was scarce but despite criticisms, patients were delivered many services at a difficult time by people who were committed to their jobs. I pay tribute to them.

I am in a minority of one in that I profoundly disagree with the proposal on St. Luke's Hospital. No fiddling about will change my mind. I agree with Deputies Connaughton, Creighton and McHugh, who referred to the reliance of the seriously ill on a service that stood the test of time when it was the only place available. Staff in the institution delivered an exceptional service, above and beyond everything that was known. Now, it appears we must move on.

We hear a lot about moving on in this country for some reason but we do not seem to move very far and we do not always move upwards. This is not a criticism of the Minister of State, who has a clear knowledge of the health service. The institution that now handles the delivery of health services throughout this country has failed miserably. It has failed in its mission statement and has failed to deliver services to the people. The HSE is incapable, it is the wrong format, it does not work and it cannot work. A single organisation cannot deliver health services to the entire country. That is what I thought when it was set up.

I opposed the abolition of the health boards. The reason they were abolished was because politicians on them asked stupid questions about service delivery. It was suggested that politicians on the health boards were holding up progress, suggesting that hospital services be improved in their respective areas. This was politics and that was not allowed. What has happened since then? They were abolished and replaced by a body that costs five times more and is remarkably less efficient. I cannot understand how that can happen. We heard Deputy Penrose referring to this moments ago. If this was comedy people would laugh about it but it is not comedy; it is a farce that so much money, time and effort has been put into providing a service for which there was great demand. Nothing happens in the end except it slows to a crawl and eventually it will dissipate into the wind and people will forget about it. I am totally opposed to what happened.

The lack of accountability and responsibility worries me. I do not know how we got to the situation where an elected Member of Parliament can table a question and is told the Minister has no responsibility. With the largest single budget in this State, there must be responsibility and accountability. I disagree with my good friend and colleague, Deputy Penrose, because I believe the Minister is responsible and must always be responsible. The Minister brings the budget to the House and apportions it to various bodies under his or her aegis. In order to protect the Minister, those in Government, Opposition and the institutions of the State, the Minister should at all times be accountable to the House for every cent. That is not too hard to accept but I cannot understand what is going wrong. The system protects Ministers. When the question arises as to what is happening in an area or why it is happening, the answer should be readily available in order to protect the institution, the Department and the Minister.

A culture has grown up in recent years of thinking that horrible, creepy politicians with long necks and red noses cannot be allowed to ask questions and run institutions because they would not understand it.

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