Billy Kelleher (Cork North Central, Fianna Fail)

I welcome the opportunity to speak about the health service plan. Those who provide health services face challenging times in managing the budgets they are allocated in the context of the budget deficit, addressing Government over-expenditure and providing a clear and sustainable pathway for the future delivery of health services.

However, we have concerns about the planned provision of health care because, while the Minister for Health strongly argued that front line services will not be diminished by the impending retirement of a significant number of highly qualified professionals, we believe he will face difficulties after 1 March. We will lose some of our best emergency department nurses and highly experienced midwives, as well as a spectrum of health professionals.

A contingency plan should have been prepared at this stage given that some knowledge should now be available about the anticipated number of retirements from front line emergency services. I do not expect contingency plans for the entirety of the health services because I accept that elective and other medical treatments are not the immediate priority but surely plans are required in respect of maternity and emergency care. Such plans would not only allow us to debate future health provision but also put people's minds at ease.

Irrespective of whether we disagree with them or, like the Taoiseach, call their remarks outrageous, we cannot ignore the consultants at the coalface of maternity services who have drawn attention to the potential risks resulting from the retirement of experienced staff. This puts the patients who will be using maternity services in jeopardy and it is unfair to those who are retiring to say they are putting lives at risk. A plan should be put in place to maintain these key services over the short to medium term while replacement staff are trained.

I welcome the Minister's comments on acute services and the clustering of hospitals in the context of reconfiguring services. Reform must be introduced through consultation and discussion, however. There was vigorous opposition to the cancer care strategy, although most people will now acknowledge it has improved the outcome for cancer patients and statistics reveal a remarkable improvement in prevention, diagnostics and treatment. The strategy was implemented in the face of considerable political opposition to reconfiguration of services and clustering hospitals, providing the appropriate support systems, centralising treatment and diagnostics to centres of excellence and outsourcing other elements of cancer care.

That was a flagship project but it was irresponsibly opposed by the people now sitting on the Government benches who are advocating the same principle in respect of acute services. The Minister's record will show that he has had a conversion on the road to Damascus. I support him in many of his initiatives but I take issue with the idea that what he said previously can be air-brushed from the record so that he can pontificate about making fundamental changes that nobody else attempted. Many people tried to address these issues but they did not receive the support they required.

It is important that we fully engage everybody involved, whether they are providing or receiving care, in regard to the proposed reconfiguration and clustering of services. We will be watching with interest what happens in Mallow, Bantry, Navan and the other hospitals to which the Minister referred. They have a significant role to play and their communities must not be led up the garden path in the same way as the people of Roscommon and Cork, in terms of St. Mary's Orthopaedic Hospital. I do not blame local Deputies for leading them up the garden path because the Minister led the Deputies up the path when he clearly stated that services would be retained. This is a historical matter but when he claims he wants to fundamentally change governance and delivery of health services we must be able to believe what he says. His actions on becoming Minister for Health were the exact opposite of what he said previously.

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