Joe Carey (Clare, Fine Gael)

What we have seen in January - both in the accident and emergency departments of hospitals and in the boardroom of the VHI - is the result of a fundamentally flawed approach to the delivery of health services in this country.

The centre of excellence model has been put forward as the solution to our health problems. I do not reject the concept but I do reject and oppose the actual reality of what this model of health care has resulted in. The facts are that over the Christmas period scores of people were left on trolleys and chairs in Limerick Regional Hospital in our so-called centre of excellence. A sign was erected in the accident and emergency department informing patients of a 14 hour waiting period. The hope of a better service has not been backed up by the investment required and indeed the promises made to the people of Clare and the mid-west region. Empty words are of very little comfort to the 18 patients left on trolleys today in Limerick Regional Hospital and nine in Ennis General Hospital.

The mid-west has been at the coalface of this transformation with the closing of the 24 hour accident and emergency services at Ennis and Nenagh. It is a damning indictment of the Minister's policy that Limerick Regional Hospital featured prominently as one of the worst performing hospitals in the country in the recently leaked health statistics report in terms of accident and emergency waiting times and people on trolleys. The people at the front line - the nurses, doctors and other staff in our hospital system - are not able to cope.

Prior to Christmas I raised in an Adjournment debate fears about the removal of cardiac service from Ennis General Hospital. The four Clare Oireachtas Members had a subsequent meeting with staff members in Ennis. At that meeting it was agreed that the Minister, Deputy Harney, would be asked to facilitate a meeting to outline in detail her plans for future services in the hospital. I welcome the Minister's commitment today to Deputies Breen, Dooley and me that such a meeting will take place at the earliest opportunity. It is critical that the current services provided at Ennis General Hospital be retained and that a clear statement be issued confirming this position following our meeting.

The hikes proposed by the VHI are scandalous and in this environment are quite simply unaffordable. It is my understanding that the Milliman report, which was presented to the Minister in September, has identified massive inefficiencies at the VHI. It is natural that an institution in place for so long and without competition for much of its existence would evolve in this way. This evening, I am calling on the Minister to publish this report immediately, have it debated and not hide behind the cloak of commercial sensitivities. It beggars belief that, despite a 2008 court judgment, the Minister has yet to deal comprehensively with risk equalisation. It is a core issue which cannot be ignored while the VHI ploughs on with its intention to increase premiums by between 70% and 80%.

I commend Deputy Reilly on bringing this motion to the House and urge the Minister to act on its proposals.

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