Brian Cowen (Laois-Offaly, Fianna Fail)

I understand the point the Deputy is making. It is within the question of trying to work within budgets. These are realities we must face. We are borrowing €400 million a week more than we are earning as a country. Of course we need to protect our people to the greatest extent we can. We are spending significant money. We are spending €16 billion this year on the health service and introducing changes and reforms. Everyone is saying changes are needed and are giving out about the health service. In fairness I know many people - as does the Deputy - who come back to us outlining that they have had very good treatment in the service. They tell us how well and professionally they were treated. They represent a far greater proportion of the representations I meet than those who met with problems. In fairness to those who work in the health service, let us stop characterising it as if it is a totally dysfunctional service that is not providing assistance for anybody.

Regarding my point that there should not be ideological objections, more than 1 million people have decided to have private health cover through VHI, Aviva and Quinn. People also make those choices. One's entitlement is not based on paying for it. A person who is sick can be brought into a hospital anywhere in the country and be treated. However, we sometimes convey the impression that it is otherwise but it is not. Where that happens I have been the first to say so. That cannot be a basis on which health care is provided and is not under our laws. In the past people have pointed up instances where a consultant's public-private mix has not been what it should have been contractually. There are many others who are conscientious in respect of these matters and do more than what they would be required to do contractually.

As far as I am concerned there is too much of everyone dumping on the health service as if it cannot provide anything. It is providing excellent service for very many people day in, day out, week in, week out. Reforms are being undertaken, some of which are succeeding. With others we are not getting the outcomes we would expect and we need to continue to work on that. In fairness, on the basis of the agreements which hopefully will be confirmed today in the ICTU we will have the prospect of working with people to transform the services. We cannot continue on the basis of status quo plus. In the foreseeable future no government will have that capacity to operate.

These are the facts that we must face up to it. We can work together to try to find solutions to these problems on the basis that we are all committed to doing the best we can with what the taxpayer is in a position to provide or we can go on with what I regard as a somewhat false debate about decrying the changes that are taking place and still calling for changes. If we need reforms, we need reforms. We cannot be going on about the status quo ante. There is plenty of opportunity for people to explore from a political point of view and it is clear that is the case in some respects. If we are going to be straight down the middle with everybody about it, that is where it is at. We need to work with people on that basis.

There is a commitment in the programme for Government on the electoral commission. We intend to proceed with it. We do not require it for constituency reviews, which as the Deputy knows are settled for the next general election under the existing arrangements. There are reforms that can be put in place during the course of the term of the Government for the future, which will seek to improve advocacy, etc., in regard to some of the issues the Deputy also raised. These are issues that are being followed up and dealt with.

There are major priorities for Government regarding the economic situation and banking, which are rightly taking up much of our legislative and other time. These are the issues at the foundation of the crisis with which we are contending.

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