Kathleen Lynch (Cork North Central, Labour)

I thank Deputy James Reilly for tabling the motion. Every second week, the health service seems to be the subject of a Private Members' motion, other type of motion or debate. I am not certain how long we can continue on this track. I am not certain people will stand for the type of rollover crises we experience in the health service virtually on a weekly basis. Given that the people who work in the health service such as gynaecologists, doctors, paediatricians, nurses, lab technicians or radiologists are all incredibly well qualified and dedicated people, one would ask why these things are continuing to happen. It is basically because there is no direct focus on management of the health service by the HSE.

Tonight's motion on patient safety arises as a result of the misdiagnoses of potential miscarriages. Most women understand that reproduction goes to the core of what we are. We may have some philosophical idea about why we are here. Some people may say it has a religious aspect to it. However, at the core it is about reproduction, which is why it is such a sensitive area and why women feel so deeply personal about it. I am sure, as I have done, all public representatives, male and female, have met many women who go to enormous lengths to have a child, including all sorts of fertility treatment. Even at the point when her specialist tells her nothing more can be done, she persists and continues because at the core our need to reproduce is fundamental to what we are.

We must consider the circumstances that bring us here tonight, which are that several women who were pregnant were told their babies were dead and that they would need to undergo a D and C to terminate the pregnancy. Only their gut instinct - I am a great believer in gut instinct - told them to seek a second opinion. Each of them then discovered she had a viable baby, who went on to become a healthy fully functioning human being. Any woman who has had such a diagnosis and went on to have a D and C must now be questioning that entire procedure. In 99% of the cases the diagnosis would have been correct. However, no matter what we do, we will never reassure those women that what happened was right in their case.

I recently had cause to visit my GP to seek a referral to a different specialty. I asked to go to a particular person. My GP said "Why not Dr. Murphy?" I said that I just did not have great faith in him. He said that if I had lost faith in a doctor then I should change doctor. My GP was very quick in telling me that because he is a good GP and he recognises the person in the round. If the entire nation has lost faith in the health service, something is seriously wrong. It is not that we do not have good doctors, nurses, clinicians and specialists in every area. So why have the people lost faith in the health service? We have lost faith because of the continual almost rollover crisis I mentioned earlier. We need to carry out some research into what it would take to bring back confidence in the system. One thing it would take would be to ensure the machinery these people use is working and that there are second checks on virtually every important decision.

We also need to look at the elephant in the room, which is the two-tier health system. We have a private health service that covers a narrow range of functions, but operates magnificently. The only way for that private health service to operate well is by ensuring that the public health service does not operate as well. Why on earth would someone opt for private health care if the public health service was as good? People would not do that. They would go to the service that operates well and gives the treatment they need, and they would have confidence in that treatment. However, in the event that the public health service is not operating as it should and the perception is that the private health service operates better, people will naturally go to where the service is better. Why are we not taking a serious look at the fact that we have had a two-tier health service that does not give the type of service that is required? The amazing thing is that this service is provided to the least well off in our society. Do we allow it to continue because it is regarded as acceptable to treat people who have lesser means in that fashion? If that is the reason, we as politicians need to seriously consider what we are doing and need to carry out a fundamental review of how we deliver our health service.

I believe three women, who were incorrectly told their pregnancies were not viable, have come forward. I am sure other women have had the same misdiagnosis and sought a second opinion. They have probably not come forward because they are thanking their lucky stars that they went with their gut instinct and decided to seek a second opinion. How will we convince people that we have a health service in which they can have confidence? That is the Minister's job.

To convince people that they can have confidence in the health service it is incumbent on the HSE to ensure we do not have the types of crises we have now. We have had the cases of Susie Long and Rebecca O'Malley. We can all name them and it goes on and on. No one is accountable. Every report we get into such crises firstly must go to the person who ultimately was responsible so that he or she can whitewash out his or her name so that he or she is not in some way held liable for what happened. When will we grow up and put a tag on such people identifying them as responsible and needing to be monitored in what they do from here on in?

If we continue in this fashion the system will continue to rumble on and continue to have crises. We will continue to have misdiagnoses whether they be in miscarriages, breast cancer or bowel cancer. We need to be adult about this. We have a health service that can function properly provided that people are made responsible for their actions. That is the only way that we will instil confidence in the delivery of health care. If the Minister does nothing else she should take a serious look at the two-tier health system that has been allowed to develop and the reasons the public health service is not as good as the private one. If she does, she will be remembered as Noel Browne is remembered.

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