Alan Shatter (Dublin South, Fine Gael)

I will respond briefly to the Minister of State. I want to come back to amendment 4a. The Minister of State's response was a little tautological. He does not want to publish the guidelines because they are really between him and the HSE, but the guidelines, at any rate, can be accessed, according to the Minister of State, through the freedom of information legislation. However, if one looks for the guidelines under freedom of information legislation, there is a possibility one will not get them because they will be regarded as confidential. I am not sure what any of that means. That is a summary of what the Minister of State said to me about it.

If the Minister of State is not prepared to lay the guidelines before both Houses of the Oireachtas for amendment, I would ask him very seriously to ensure their publication. Guidelines directing the HSE as to what information and documentation it should provide and the circumstances in which it arises, are no more confidential than publishing guidelines for the protection of children. If the guidelines are not published, how do the 100,000 people, whom the Minister of State describes as employed by the HSE, know what is in them? He is not suggesting they are going to be secretly given to 100,000 people. He is not even suggesting, I assume, that the HSE has the capacity to coherently communicate what is in the guidelines to its employees because for ten years it has not been able to communicate the child care guidelines.

If this is a serious attempt by Government to ensure an organisation that has utterly failed on a whole range of crucial issues to keep Ministers and a Department informed of events is now going to change simply by the issuing of a guideline that no one sees, other than a few officials in the Department, whoever happens to be the Minister of the day and someone in the HSE headquarters, this is not going to work. Indeed, no one should have to pay - I do not care if it is €5 or €20 - to get access to a piece of information that should be in the public domain.

The Minister of State criticised the Leader of Fine Gael for referring to the X-ray scandal as a scandal and as catastrophic. For a lot of people it was a scandal and they were concerned it could have catastrophic consequences. We have had so many revelations of failures within our health service that emerge months after the failures have occurred, in some instances, years after the failures have occurred, and where the information is either drip-fed to the media as a consequence of a journalist getting some information or a victim of failure going public or the acts of a whistleblower, as the Minister of State describes them. All of this has been happening because there is an ethos and culture of obsessive secrecy within the HSE and at middle and upper management levels, a cover-up mentality for fear that when things go wrong, someone might be held accountable. Of course, the irony is that no one is ever held accountable. This is an organisation where no one in a management position accepts accountability for everything. Ministers and Ministers of State then say that because they cannot micromanage the service, they cannot be held accountable either.

This is a philosophy of decent people whose political parties have been in Government for far too long and who are overwhelmed by an institutional ethic which believes the public should know as little as possible and by the desire to never be held accountable for anything that ever goes wrong. It is part of what is rotten in our system of governance and it applies to the HSE. This is not a criticism of the extraordinarily dedicated professionals working in frontline services or of some of the excellent people in middle and higher management. Of course there are good people within the organisation - many good and dedicated people. However, that does not take away from the fact that the structure of the organisation and the manner in which it operates has been consistently exposed to be dysfunctional in a broad range of areas, and certainly with regard to dealing with the public and issues of transparency and accountability where there are problems.

If the Minister of State intends to issue guidelines on these issues, there is no coherent reason for them not to be published. These are general guidelines. If he has concerns because he does not want to be alarmist about something - which, ultimately, may prove not to be a real cause of concern - or concerns about publishing specifications on a particular issue before he knows the information he is seeking from the HSE, I would have some sympathy for those concerns. The Minister of State could hear about something that would be a general cause of public alarm if it proved true and he might specify he was seeking information on it. Then, when the information comes to him and assuming it is comprehensive, accurate and truthful, it may well be the case that there is no problem at all. I can understand why some discreet specification about a particular issue should not necessarily be immediately published, but a general set of guidelines should be published.

Deputy Jan O'Sullivan referred to the review group, as did I and other speakers. It is important that all the information it requires is furnished to it. When the group receives that information, who is to know how comprehensive it will be, particularly in the context of the revelations that have occurred with regard to the failure of the HSE to properly maintain files relating to children in care? Files are maintained in a haphazard fashion, information is missing and photographs are found on the floors of storerooms with nobody knowing to which files they should be attached. Who knows to what extent this information will be the comprehensive information required?

Another defect of the Bill is the fact no statutory powers are conferred on the review group to interview or talk to individuals employed by the HSE who were involved with a particular child or young person in a care setting who has died in order to get additional information if required. Nor is there any provision that ensures that both current and former employees of the HSE will co-operate in providing such information. This is a huge lacuna which we will address later.

I have a concern also about an issue that has not yet been addressed. I have no doubt that when the Minister of State established the review group, he did it with the best of motives. I know that he doubted the information he had been given at the time, because if he did not doubt it, the review group would never have been established. The information we had been given was that 23 children had died in care and that is the information the Minister of State gave to the House. I have no doubt - I may be able to confirm this if I can access the information through a freedom of information inquiry - that the Minister of State was vigorously trying to get the HSE to clarify that information but was coming up against a brick wall. I have no doubt that he came into the House in good faith and told us that 23 people had died in care but thought the information was a bit dodgy and could not be relied upon and that is the reason he established the review group, to require the HSE to validate the information. He told the House the group would complete its work by 31 December 2010.

We now know that 188 people died in care, over 100 of whom died of non-natural causes. I am concerned that the review group, which must examine all the papers and documentation and make such other inquiries as it deems appropriate, will be overwhelmed now by the volume of work it must do. To what extent has that been considered by the Minister of State, the Government or the review group? How can it carry out its task now? It is quite a different matter to examine the files and papers relating to 23 deceased young people than to examine the files and papers relating to 188 young people, and possibly more if it turns out the HSE is still wrong about its figures. Will the Minister of State say something to the House about that during the course of this discussion?

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