Alan Shatter (Dublin South, Fine Gael)

I have difficulty with what the Minister is saying because I do not understand why there is a discrepancy between what the explanatory memorandum states the Bill does and the actual content of the Bill. It is very unusual because these documents are prepared very carefully. Those who drafted the explanatory memorandum felt, when referring to this very particular area, the need to include the phrase "including political accountability to the Oireachtas". I do not understand why the Minister will not accept my amendment or why the Office of the Attorney General did not include that wording in the Bill. If the Minister of State says the legislation is to facilitate political accountability to the Oireachtas, he should accept the amendment. The wording I seek to include makes sure that the issues I am concerned about will be addressed.

The problem is that the Minister does not regard herself as accountable for anything to do with the delivery of services. That is an important issue and I disagree with the Minister of State's view on it. The delivery of services is not just about the issuing of an individual medical card to an applicant who may be entitled to it, it is about a range of issues. Included are the operation and management of accident and emergency units in hospitals, the reason beds may be vacant in a ward when there are people lying on trolleys in the accident and emergency section, and the reasons X-rays are not properly reviewed, which might affect hundreds of people. These are issues about the day-to-day running of our medical services.

The Minister does not regard herself as accountable to the House except when there is a great uproar and public scandal and it ceases to be credible to say in the House that she will send a letter to the HSE about it. If the failure is of sufficient enormity, the fiction that the Minister is involved only in the development of policy and that the HSE is involved only in delivering the service is suddenly sidelined and the Minister comes into the House to report to it.

When there is not a scandal, catastrophe or revelation about something that should occurred and it is a general Dáil question about a matter of concern, it is referred to the HSE.

The Minister of State mentioned medical cards. If a Member asks a question now about the medical card, he or she will be told the Minister will write to the HSE. Of course, the Member might be told, as we have been for weeks - the Minister of State might clarify where we now stand - that unfortunately we cannot even communicate with the HSE because there is an industrial dispute and it will not tell us anything. I presume the industrial dispute is over. I have not tabled in the past couple of days a Dáil question that would have generated, as questions did until last week, that sort of response. The Minister of State might clarify whether the industrial dispute is at an end.

We were in the ridiculous position where we had a Minister telling us that she did not really deal with this directly and she would communicate with the HSE but she cannot because there is an industrial dispute and if we are still interested in the issue, would we ever table the question again. My colleague, Deputy Durkan, on a regular basis on the Order of Business, persistently and correctly pursued that issue.

Let me tell the House something about medical cards. I have a situation in my constituency in which, I think, the reply issued yesterday that the Minister was writing to the HSE and it would respond to me, where persons who are entitled to a medical card because they have certain serious illness and who get them on a discretionary basis are now having medical cards issued to them for two months at a time and they must keep on reapplying because the staff shortages dealing with the progression of medical cards are such that no one is willing to take responsibility to issue a medical card for 12 months. I have one very elderly pensioner constituent who is a distressed individual who every two months thinks her medical card will be cancelled and must keep reapplying.

To my mind, that might be an individual issue worth bringing into this House to which I should get a substantive response, not a Minister telling me she will write to the HSE, because that is an issue that does not just affect that individual. How many other individuals does it affect and how much public money is being wasted in repetitive applications being processed and temporary medical cards repetitively being issued to individuals who should get their medical card as they did heretofore for a year or longer without having to repetitively apply, and individuals who are distressed by serious illnesses who do not need the worry, particularly when they are elderly, of fearing they might suddenly be deprived of their medical card? That goes beyond the micromanagement of the health service.

This is an amendment I would have hoped the Minister of State would accept but, of course, I have learnt in this Dáil that Ministers generally do not accept any amendments. I usually get to this point in these sort of proceedings where I really wonder why I burnt the midnight oil tabling any amendments and maybe we should just abandon Committee and Report Stages. I feel I have a public duty to raise these issues and I will continue to do so. I will conclude because I want us then to move on and deal with some of the other amendments that need to be addressed. I thank Deputy Jan O'Sullivan for her support for this amendment.

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