James Reilly (Dublin North, Fine Gael)

I thank everyone who contributed to the debate. I will point out a few inaccuracies from the other side of the House. Less than 10% of improved longevity in the past 20 years can be attributed to health care once vaccination is excluded from the figures. Notwithstanding the contention of the Minister of State, Deputy Barry Andrews, that the Government puts patient safety first, there is no patient safety authority. Last might, the Minister for Health and Children did not want to distinguish between elective general surgery and elective orthopaedic surgery. She fully admitted that, despite the protestations of the clinical director in the north east that it was a question of patient safety and standards, it was about money. The people know where the Government is focused.

Those who suggested that hospitals or other services were excluded from this motion did not want to read it. It reads "for example" and is not an exhaustive list. The Minister failed to understand the motion. No one on this side of the House has ever accused her of being stupid, so I can only assume she deliberately misunderstood for her own political ends.

This side of the House has acknowledged the need for savings in the health budget, but not at the cost of frontline services. Rather, it should be by cutting out the waste and gross inefficiencies in the HSE. This is what needs to be done and is where the focus should have been for the past six years. Instead, the Minister allows the HSE to take the lazy, easy way out, namely, to hit the front line and hurt patients. The motion is clear - find the necessary savings within the waste and inefficiencies of the HSE and not at the patients' expense. This means negotiating, consulting, compromising and engaging in conciliation with all stakeholders, but always with the understanding that the key stakeholder is the patient.

The Minister read out a list of costs for retaining frontline services at several hospitals. We acknowledge that savings must be made, but not by cuts in front line services. There is enough waste and inefficiency in the system to allow for these savings without affecting the front line. Herewith, a menu to choose from. The annual overtime bill is €1 billion. Why has this not been addressed? Some €121 million is spent on taxis, but tendering and proper logistics could surely reduce this. Some €60 million is spent on medico-legal fees, of which €20 million goes to lawyers. Surely savings could be made in this respect. The 6,000 redundancies in administration and management identified by Professor Drumm could yield hundreds of millions of euro in savings, yet all we get is talk and rehashed plans.

Where generic drugs are concerned, the drug reference pricing bill has been put on the long finger. It could save €200 million, but all we get is more talk. As to HSE west, Deputy Ring referred to the €10 million outstanding from insurers and the €5 million lost through absenteeism. Why is it a surgeon can say to me that he or she can only do nine procedures per week in a public hospital but ten on a Saturday in a private facility? Clearly, there are considerable inefficiencies. In tomorrow's Irish Independent, we will read of tens of millions of euro spent on outside consultants in the past three years. We were promised this issue would be tackled, but it goes on.

The Minister is like an observer looking on while taking no action. Six years in the job and all she does is outline the problems. She never solves them. Last night, I mentioned Taiwan because it introduced universal health insurance in 1995. One could get a hip done in one or two weeks after being diagnosed, yet it only spends 6.4% of GDP on health. Last night, the Minister told the House that we spend 11.8% of our national income on health.

We know that savings must be made and where this can be done. What we are trying to get across is that there is another way to make them. Consider the menu of cuts I have supplied instead of looking to those with chronic illness, like the six year old child with diabetes, the middle aged man with chronic lung disease or the woman with rheumatoid arthritis, those with a disability or those with mental health issues, especially children. As Deputy Neville pointed out, children were placed in totally inappropriate adult facilities. There are young people with cystic fibrosis fighting to catch their breath as they wait on one broken promise after another for their new life-saving unit at St. Vincent's hospital. How many more must die prematurely before they see that false dawn? The terminally ill fight for their lives without medical cards being available to them. I ask the Minister, Deputy Harney, to give patients and our people a break and crack the whip over the wasteful and inefficient HSE.

It is the duty of Opposition to expose, oppose and propose. Tonight in this Chamber we exposed the deficiencies and flaws of the HSE and passionately opposed them. We proposed sensible and responsible alternatives. I fear the Minister and her Government will not listen but I hope the people have heard.

I commend the motion to the House.

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