Micheál Martin (Cork South Central, Fianna Fail)

In Question No. 5, I asked the Taoiseach whether he had put in place in his Department rather than just in his office any expertise on health policy. I find it incredible that the answer is "No". Given that the Department of the Taoiseach through the Taoiseach chairs the Cabinet sub-committee on health, it is unacceptable that there is no health expertise within the broader Department to inform the Taoiseach's work as chair of that sub-committee and to bring certain perspectives to its work.

The Taoiseach's fundamental difficulty is that he made commitments on health that could not be realised. In recent months, he has broken hospital after hospital. Roscommon is the classic example, but there are examples in Sligo, the orthopaedic hospital in Mallow and the many others in respect of which he made cast iron guarantees through letters and commitments in advance of the election. He has needed to resile from all of them.

At the macro level in terms of the advice and expertise required, the programme for Government contains two fundamental commitments. First, the move to a not-for-profit trust with insurers for every local hospital. This would be a retrograde step. Insurers would deal with hospitals directly to control costs. The Taoiseach mentioned Ennis and Galway. I understand that tenders have been sought for private outside contractors to manage those hospitals. He needs to spell this situation out further. We need a more comprehensive debate, as it is a specific change.

Second, a pathway to universal hospital care insurance was committed to in the programme. I note the word "pathway" has been introduced for the first time. It was never used prior to the election.

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