Timmy Dooley (Clare, Fianna Fail)

I welcome the opportunity to contribute to this debate and I echo the sentiments expressed by Deputy Cregan in regard to the Minister, Deputy Harney, who I have found, in the years I have been in this House, to be extremely open to new ideas and prepared to engage and deal with difficult situations where they arise. That is not how she is characterised outside the House. Like the previous speaker, I find it difficult to understand how she can deal with some of the slurs and insults that are thrown her way. I suppose it is a test of her character and she has won it well.

We all accept that the protection of front line services is of the greatest importance and the Minister and the Government are striving to deal with this, especially in the current difficult economic climate. There is a requirement for all of us to show leadership and to try to bring the people with us. To some extent, I was taken by how Deputy Reilly put forward the Fine Gael proposal. He spoke about the necessity for money to follow the patient and set the overall framework of how his party would deal with the health service. That is fine and the Minister responded to some areas where she found inaccuracies. At least the Deputy was talking about a co-ordinated plan but speaker after speaker who followed him complimented the Deputy for his proposal and then sought to undermine what he had said by considering local issues and discussing services rather than patients. Deputy Reilly clearly stated that money should follow the patient and I respect him for that. He said that, in so far as one can, one must focus delivery of the health service on the patient. That is clearly set out in the way reconfiguration works.

I will not go over the same ground again but the Minister referred to a situation where a Deputy in County Clare sought to undermine what is being done, although it had been agreed by the unions in the Croke Park deal. I find it difficult when a nurse comes to me and complains in a clear way that she does not want to move to another hospital. On a personal basis I can understand that but if the matter has been agreed by the unions and is in the best interests of the patients concerned, what end are all of us here to serve? We must be careful and stop fanning that flame, undermining the health service and the majority of its people who deliver a fantastic service. We have to get behind them and their union leadership and work towards a reconfiguration process which is based absolutely on patient safety. That must be central to the delivery of our health service. People must have confidence in the care they receive and have the best possible outcomes. I have seen this with the reconfiguration process as it has developed in Ennis. It was very difficult at the outset because there were certain political people on the other side who had local interests at heart. Using fear, some put forward the notion that if the reconfiguration process were to take place as outlined by the Minister and the HSE in the region of 20 people per year would die. That did not happen and, of course, there are no headlines when something does not happen. It is very hard to propose the notion that people's lives have been saved as a result of configuration.

We must continue with that work. It is not only about saving money but in the financial position in which we find ourselves, as the Minister set out, the incremental increases that had been occurring year on year are no longer there. This will force change. I am concerned that certain people on the other side have told Deputy Reilly that they are not prepared to accept that change. They have said as much in his company albeit behind his back. They are not prepared to accept that change which is necessary. If the extra money does not exist, it is clear we must do more for patients with less money but only if we work differently. The unions recognised this in the Croke Park agreement. Deputies in this House must show leadership and find ways to do this. Deputy Cregan identified ways in which it has been done and I have seen other examples in the county I know best. It is possible to move forward, holding the views of workers and management to hand, and to develop a proper model that can be worked more efficiently from both a cost and a labour-intensive point of view.

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