Finian McGrath (Dublin North Central, Independent)

A Cheann Comhairle, I thank you for allowing me to speak on this Bill.

All of the citizens of this State are entitled to a decent, quality health service as a right and we should never turn our backs on that core principle. This is very important. It costs money and we will have to pay for it. We have ignored this in the broader debate on our health services. This is why I support the core value of a universal health service. If they can do it countries like Cuba, blockaded by the US for over 40 years, we certainly can do it in Ireland. I urge the Minister to look at the health service in Cuba and look at the example of a country that is being hammered economically but still has a top quality health service. There are strong links between Beaumont hospital in my constituency and many of the health services in Cuba.

I feel very strongly that there is too much talk about reform and change, and not enough action on providing a quality health service. However, today's Bill is part of that reform and I welcome the constructive proposals in it. The Medical Practitioners (Amendment) Bill 2011 is intended urgently to assist in addressing the current difficulty with vacancies for non-consultant hospital doctors. The current level of vacancies at NCHD level has significant implications for the maintenance of acute services, particularly in the smaller hospitals and in certain locations where vacancies are concentrated. The reasons for the shortage of junior doctors are quite complex, and include the fact that the posts in question are mainly non-training posts and therefore not attractive to doctors. There is a general international shortage of junior doctors. That is the reality on the ground.

When we examine the details of this issue and when we talk about acute services and certain smaller hospitals, we have debates like that yesterday about Roscommon. It is misleading for people to say that TDs and the public want hospitals at every crossroads. We all accept that some hospitals have to specialise and be centres of excellence for serious illness. However, the debate about Roscommon is that the people there have a right to accident and emergency services, just like the people I represent in Coolock, Artane, Beaumont and Marino.

The centres of excellence are also a real issue and must be examined. However, the other issue is that false promises were made to the people before the last general election. If the Minister had not made these promises, he would not have had half the hassle he had yesterday. Politicians should not go out during election campaigns and make promises they cannot deliver. The common comment to me on the doorsteps was to go in there and try to fix the mess that is going on. If we are straight with people, they will be straight with us and will be very respectful.

It is also important to say that we have some examples of where the health service is working, and I commend those directly involved. I strongly campaigned for and supported the introduction of a new cystic fibrosis unit in Beaumont hospital, which cost €3.8 million and which is an excellent service. It deals with young children across the north side. Many of us have been fighting for a unit in St. Vincent's hospital, and the Minister supported it in Opposition, but the good news is that this unit is now being built and will hopefully be finished in a matter of months. We had experiences of delays and bureaucracy between the Department and the HSE, and this is the problem with our health services.

Another example of good practice in my constituency is the orthopaedic hospital in Clontarf. We campaigned for that locally and the €16.6 million required was delivered four years ago, and it is now providing an excellent service. It is a centre of excellence for many people in the orthopaedic area. We have many examples of good practice and good services, so let us try to implement them right across our health service.

There is an issue in respect of the registration of doctors from countries outside the European Union. I commend those doctors who come from non-EU countries and who have made a massive contribution to the health service here. There are also language issues which we must face up to and which are raised regularly with me.

I urge reform and change and call for a top quality public health service. Our people need a quality service based on equality of access. This Bill is another part of that process. I strongly support Deputy Ó Caoláin's point that we need a review of this legislation in the future.

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