Jerry Buttimer (Cork South Central, Fine Gael)

I welcome the legislation and cross party support it. It is regrettable we are in this position. We should never be in a position whereby patient safety and delivery of service is in crisis and it should not be allowed to happen again. I commend the Minister, Deputy Reilly, for his stewardship of this issue. The shortage of non-consultant hospital doctors did not arise overnight. This matter was not flagged on a Monday morning by people inquiring of one another how their weekend went discovering there would be no doctors from 11 July. This was known about for two years.

Many members opposite have been complaining about this matter. Where were members of the previous Government during the past two years in terms of delivery of service? Who was in charge? Who was steering the ship of State? I remain unconvinced that anyone was steering the ship in the area of health for the past 14 years. I will come back to that issue. The shortage of non-consultant hospital doctors is an urgent matter. The Minister and his officials have been proactive in dealing with it. I am confident the Minister, Deputy Reilly, will be a reforming and pioneering Minister.

The mismanagement of our health service must stop. We can no longer engage in quenching fires on every street corner and in every county. That must stop. The people want a Minister - they have one now - who will be responsible, accountable and with whom the buck will stop. People no longer have confidence in the Health Service Executive. That confidence has been shattered. We need a new regime and joined up thinking which will ensure delivery of service. The Minister and new board must work in tandem. I call on the Minister not alone to get rid of the board of the HSE but to dismantle the HSE. The Minister should go back to the drawing board and start again. What happened is wrong.

Deputy Durkan is correct that there is no accountability in the HSE. The bureaucratic system that has unfolded as a consequence of the creation of the HSE has not worked. It has failed. The Department of Health has acquiesced by passing the buck between A and B, taking no responsibility and leaving no one in charge. It is time this changed. I say that knowing that many of the staff who work in the HSE are good public servants who do great work. However, there is no leadership or joined up thinking in this area. In my humble opinion, we should get rid of the HSE and start again. I praise the Minister for bringing a resolution to this issue.

Deputy Mitchell O'Connor asked a good question and I ask the same question. Why do so many of our young junior doctors emigrate? Career advancement must be made available to our young qualified doctors.

I very much welcome section 8 of the Bill. I am pleased that there will be no issue of quality or dilution of service and that there will be a rethinking of how we treat our non-consultant hospital doctors many of whom have been unfairly treated regarding their recognition. There is a strong case to be made for career advancement and not just to have them used as stopgap measures in the delivery of a health service. Without these doctors there would be no health service and we would not have a service of the highest quality being delivered. It is important that training for junior doctors and professional development are included as part of their career advancement. Many doctors in our hospitals speak of how they have been treated as we heard on "Morning Ireland" and other radio programmes.

We need a new vision, approach and dynamic in the health service. We must never allow vested interests to monopolise and dominate. We must never allow the chosen few to become the loudest voice. It is important to get what is best for the people, in this case patients. The patient must be at the centre of a health policy. Having listened to Deputy Cowen and other Members speak, we need a debate on the centralisation of services, which in some cases is not the right approach. We need a fundamental plan that is joined-up, real, practical and implementable. While I understand we live in different economic times from when we started on the journey of reform of the health service, we still spend billions of taxpayers' money every year, some of which is wasted.

While I may be in a minority in this belief, with political representation on the old health boards there was accountability and answers were being given because people had to report. Deputy Cowen spoke about the Dublin mid-Leinster regional health forum. The creation of health fora was the greatest ever cosmetic exercise in appeasement by a Government to its backbenchers and local authority members. Its reports are not worth the paper on which they are written. No official attending a regional health forum is worried or concerned about what might happen because nothing happens and it is just a forum. We need to go back to reality and there must be delivery of service with accountability and real responsibility given. The Minister is absolutely correct in insisting on not providing more funds to a hospital that has overspent. If Deputy Kelleher overspent at home, his wife would come and ask where the money had gone. If I overspent my bank manager would be on the phone asking where it had gone. We need to be real and the Minister is being proactive.

I am glad we have cross-party support on this measure, which is about the patient, delivery of service and ensuring what we do is right. However, we need to go back to the drawing board regarding the vehicle to deliver the health service the country requires.

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