Bernard Durkan (Kildare North, Fine Gael)

-----the Minister said that when a child is ill, a parent will bring that child anywhere to get treatment. That is not true. The parent will bring that child to the nearest location where the treatment is available. This is because, as Deputy Penrose said, time is of the essence. One does not have time to be fancy footed about the matter at that stage. If the child has an illness that requires instant treatment, the parent will bring that child to the nearest hospital. That is where the parents hope something can be done. If an additional five minute journey is required, the parent might not get through traffic lights, things might not happen in their favour and there may be a road stoppage or a pothole. It is a case of minutes at this stage, as any parent who took a child on an emergency rush to the hospital will testify. I cannot understand why we lost sight of this and the notion of centres of excellence 50 or 100 miles apart is developing.

It is suggested modern transport will handle the difficulties and that we will have a helicopter service. We had these aspirations during the Celtic tiger era when the Celtic tiger was roaming up and down the country, with evidence of its existence at every crossroads. What did we get? Nothing. The health service has disappeared through the floor and hospital beds are being closed all over the country. The current Administration, on whatever basis it is meant to stand, has failed to deliver services to the people of the country.

I did not address co-location and I am surprised it has not been mentioned to any extent so far. I do not understand where it came from and I cannot understand why existing hospitals will be sacrificed, with some sold and some demolished, in order to make way for co-location where public hospitals and private hospitals are side-by-side on the same ground. This is duplication. What will happen when they close half of the beds in both hospitals? That is what will happen if it continues on the way it is now.

I despair at the progress in the health sector over the past number of years. An eminent surgeon made a comment I agree with, saying that all health institutions should be centres of excellence. We are not supposed to have a second and third tier health service. If we have centres of excellence and they work the way they should in theory, there will be investment in high technology and everything required in the centre of excellence. Below that, there will be another tier. There will be less investment and it will not be a clean hospital. The tiles on the floor will not be cleaned or polished. How will its third tier status be determined? In the situation where a patient is on the road in an ambulance, the minutes count. It will not be possible to travel 50 or 60 miles required to get to the centre of excellence. It may not be possible to travel for hours and in this scenario a serious problem emerges. I cannot understand why administrators do not understand this.

No orthopaedic procedures are taking place in Naas General Hospital. It shares its services with Tallaght hospital. The theory in the beginning was that the backup services would rotate between Naas and Tallaght so that patients from the surrounding areas could travel to Naas. An invisible hand seems to make many decisions in this country and it took control of the thinking on this matter so that the hospital services were closed down. There is a clean-air operating theatre and the most up-to-date equipment in the world in Naas General Hospital. It was put there for a purpose but it is unused.

The sad part is that I cannot get a question answered in the House. We can continue asking questions of the Minister to indicate the total cost of private health insurance but we cannot get an answer. What has gone wrong with this country? I cannot understand it. When I came into this House, if a Deputy tabled a question of that nature and was not answered, there was uproar and the House came to a standstill the next day. The Minister would be asked to resign because he or she failed to do a ministerial duty. I cannot understand where we have gone wrong and how ineffective we have become. Members on the Government and Opposition benches have allowed this to happen and we need to be alert to it at all times.

The degree to which we accept second-grade decisions and a fob-off when we ask straightforward questions is our downfall. It has declined to the point where we no longer exist or need to exist. In that case, someone should organise a secondary parliament, the HSE parliament, where people could get elected, ask questions and get answers to questions. They could then deliver services they were supposed to deliver in the first place.

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