James Reilly (Dublin North, Fine Gael)

I take this opportunity to sympathise again with the women, their spouses and their families affected by the misdiagnoses at Our Lady of Lourdes Hospital. The Minister referred last night to being serious about patient safety. If she is serious, how can she stand over overcrowded accident and emergency units, a situation she promised four years ago to treat as a national emergency? This year we saw 500 people lying on trolleys in a single day. How can she stand over the 20,000 cancelled operations last year? Behind those figures are real people in pain waiting for treatment. Their families make arrangements to look after children and so on so that their loved one can undergo treatment only to have their appointment cancelled at the last moment. How can she stand over an increase of 70% in delayed discharges? People are lying in hospital beds who do not require treatment. They will miss out on the opportunity to avail of rehabilitation which would have allowed them to go home eventually. Instead they are destined to remain in long-term care.

Louth County Hospital has been downgraded and Monaghan and Cavan hospitals closed, with all patients shoehorned into Drogheda, an area that is a natural commuter belt for Dublin and has seen the attendant huge population increase in recent years. It is an insult to the people of Monaghan. People in Monaghan who suffer a multiple trauma are taken by ambulance to Drogheda hospital and because they were not treated in Cavan hospital, they cannot avail of the remaining rehabilitation services at Monaghan hospital. That is the final insult.

The Minister spoke last night about whistleblower legislation, but the reality is that the provisions of that Bill are contradicted by the gagging clauses in the consultant contract. People do not feel safe reporting their concerns because in doing so they will find themselves isolated and in difficulty with their employer. The Minister stated last night that the scanner in question was not clapped out, but that is precisely what the report indicates when it refers to "evidence of fatigue". The Minister said such machines should have a seven-year life span, but that depends on usage. A machine that is used as much as this particular one was is bound to be fatigued. The Minister assured us the review will tell us the full story. It cannot do so because it can look only at notes and files; it cannot review the live ultrasound examination that took place. A picture cannot identify a heartbeat; only a living image can do so. Second, if that picture was taken from the wrong part of the womb and the foetal sac was in another part, all we will see is an empty womb.

The Minister spoke about creating a system that will be safer for patients. Rather than minimising the impact of human error on patients, we have a system that seems to maximise it. We are all aware that human error is unavoidable and inevitable, but a good system minimises its impact on the patient. It is commonplace in industry to have maintenance contracts on machinery. Where was the maintenance contract for machines which can potentially determine the termination of a live foetus and deprive people who have waited years for a family? That is simply not acceptable. Add to these deficiencies the pressure on doctors, sonographers and nurses in Our Lady of Lourdes Hospital and other hospitals throughout the State and one is faced with a disaster. I spoke to one woman who told me that the sonographer's pager bleeped three times in the course of her ultrasound. That is bound to lead to errors.

The solution we are offered is the provision of a sonographer for four hours per day to a unit in the Ceann Comhairle's constituency where more than 4,000 babies are delivered per year. By any international standard there should be two if not four full-time sonographers working in that unit. The necessary balances and checks are not in place. We are reacting rather than being proactive, which is what a patient safety authority would do. Where a single incident is reported to such an authority, action could be taken. Instead people have no choice but to revert to the courts or to forgo their privacy by approaching the media. We may complain about the media but thank God it has at least exposed this and other problems.

I congratulate Melissa and Michael Redmond on opening the flood gates on this issue. Unsurprisingly, the initial response from the HSE was to claim it was a rare occurrence. We now know it was not. If we had a patient safety authority these issues would be acted upon as soon as the patient made a complaint or expressed a concern. The Minister said last night that the Health Information and Quality Authority can play this role. A representative of that body has expressly told me that it cannot be an advocate for patient safety. I challenge the Minister to ask Tracey Cooper whether or not she told me in a conversation that the authority cannot fulfil that role.

Before Members opposite vote down this motion, I ask them to consider the €60 million paid out last year in medical and legal fees, of which €20 million went to the legal profession. I have nothing against the profession but that money should have gone towards compensation of patients. People revert to the courts because they do not have a safe place to go. Members opposite should remember the late Ann Moriarty from Clare. They should recall the words of Rebecca O'Malley and the advocacy of Patient Focus, Dignity for Patients and other groups. They should consider the safety of their own loved ones and people in their own communities. Let us ensure there is a safe place to which everybody can take their complaints, worries and concerns. Nobody should be forced to go to the judicial system or the media. Let us afford all our citizens - women, men, children, those with mental health issues, those with disabilities, whether physical or intellectual - the comfort of a patient safety authority. We can estimate the cost of a patient safety authority but we can never underestimate its value.

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