Bernard Durkan (Kildare North, Fine Gael)

I thank the Ceann Comhairle for affording me the opportunity to raise this issue which has been the subject of much debate and parliamentary questions in recent days. It relates to one of the symptoms that needs attention - no pun intended - in the delivery of health services. It concerns a dental service put in place to meet a local need at a time when it was decided that the persons whose interests should primarily be served were potential patients. This was done at a time when very few financial resources were available. It was a good decision to meet the needs of people in the area concerned by the delivery of services from the centre to the locality where they were needed. Unfortunately, however, a decision was made, not by the Minister but by the HSE, that the service would be phased out and relocated to a central location. As one who opposes the concept of centralisation, I view this decision as a retrograde step.

I accept it may not be possible to reverse the decision at this stage, but I call on the Minister to address the issue and take full control of it himself. He has committed to doing so. I welcome the decisions taken already that the HSE will no longer be the master of its own destiny in the sense that the funding it receives comes from the Exchequer and that it has a responsibility not only to this House but to the people also. I do not wish to delay the House other than to say this service is vital. It has been well supported by the local community. There is no reason to make this the decision on its removal other than the internal play-acting that usually occurs in large organisations when they want to be seen to, allegedly, be making savings, the net results of which are highly questionable.

I ask the Minister of State to give some indication as to what is likely to happen because, far from witnessing a reduction in services in the area concerned, there is a need for enhanced services. I was appalled recently to find that the decision-making layer within the HSE had made decisions about the delivery of services in this rural area. Some of the decisions made do not provide for the continuation of services in place since the 1950s. That is what is called rationalisation. Rationalisation in that fashion means the end product is a reduction in services for the people who must be served first. Services are not provided for the benefit or convenience of those providing them, the HSE or administrators. They not provided for anybody other than members of the general public whose interests must be served first.

It would be hugely beneficial, not only from the point of view of the community in Carbury or Derrinturn in my constituency but also for other areas throughout the country, if this issue was addressed once and for all. Let us determine who dictates policy. Is it the taxpayer, the Minister who provides money for an outside body or quango, or somebody else, some administrator who considers he or she has a critical role to play and that he or she can make waves where nobody else can? There is a unique opportunity for the Minister of State to give some indication as to who wields power.

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