Mattie McGrath (Tipperary South, Independent)

I accept that. I am talking about my party in Government, and about what I saw with my two eyes open in the past four years. I accept that we attacked the front line services and I am ashamed that was not addressed. The Minister, Deputy Reilly, promised to tackle it but he has not.

I could raise issue after issue but the fundamental problem is that the HSE is a big, monolithic organisation that is not fit for purpose. It should be on the scrap-heap. It should be totally disbanded because it has grown lazy, lethargic, inept and, above all, it does not answer to any public representative or this House. That is the shameful aspect.

The Acting Chairman, Deputy Tom Hayes, knows what I am talking about. We have been dealing with different managers in hospitals in south Tipperary. We are told one thing today and a different thing tomorrow. They move off to different careers. They move off to a reconfiguration service. They are no longer working for the hospital. They are there and getting paid out of the budget but they are now working for the reconfiguration part of the service.

Reconfiguration - it is a wonderful word. They create new words every couple of years to justify their jobs and their positions while pillorying the ordinary people of this country and deny them the basic services they are entitled to and had ten years ago. Take the mental health aspect, on which there is a spend of €55 million. Mental health services have been the poor relation for decades. We all voted for A Vision for Change, as the Minister of State, Deputy Kathleen Lynch, reminded me. Of course we did. We welcomed it because the draconian institutions must be closed and services moved on. However, part of the draconian institution that was closed in my town is now plush offices, more lavish than the Minister's office in this building. The walls are adorned with big paintings and pictures of previous officials.

This was hijacked and plundered by people who wanted to enhance their careers and to hell with the service. These people arrived in from a different land two years ago and told the board of South Tipperary General Hospital at a Tuesday night meeting that they were closing St. Michael's psychiatric unit - off the agenda - without any discussion, consultation or otherwise. The consultants and board present were shocked and contacted the local Deputies. Nonetheless, the director came on the radio on the Thursday and announced it publicly because the consultants had leaked it. Is that respect for consultants, staff or elected representatives, including county councillors who had served on the Southern Health Board? It is not.

This issue is still continuing in our town and, more importantly, in our county. They hived off all the north Tipperary patients and told them they had to go to Limerick. The north Tipperary representatives fell for that, which surprises me, but that is their business. Now, it is found they have not gone to Limerick but instead have gone to Ennis, although the people of Ennis have enough to put up with. I recently spoke to the Labour Deputy from Ennis and he complained about beds being inaccessible for his own constituents in Ennis because there is no space. It is playing with figures but, more importantly, it is neglecting and failing to treat people as human beings and as honest people who have worked and, for whatever reason, ended up in this situation.

What is going on in south Tipperary at present is an outrage. I thank the Minister of State, Deputy Kathleen Lynch, for at least yesterday acknowledging the facts in regard to closing acute psychiatric beds in St. Michael's unit. There is no comparison with St. Luke's Hospital, which we agree should be closed and, for that matter, should be bulldozed. However, they will not bulldoze it because they have big offices inside for their own people - some of the offices are as big as half a ward. It is madness. That is where the money was spent, not on the beds, not on patient services, not on outpatients and not on more psychiatric consultants, where it was needed. It was spent furthering their own careers in fine, plush surroundings. It is an abomination, a disgrace, a travesty and an injustice to the public of this country. That is what has happened.

Then we have reports like this one. They would not fit in the Custom House, all the reports that have been done on different hospitals - this report and that report, and paying experts and consultants to come in to prepare them. I do not mean medical consultants but outside consultants, enough to keep an industry going. That is what happened. They took the eye off the ball and left people waiting for medical cards.

Whoever made a decision to move the medical card system to Dublin should be sacked. It has been a disgrace of a system. While I will not say they are losing more files than they are dealing with, they are losing files by the hour. It is another disastrous move. Ordinary people, including cancer patients who are very sick, have had files go missing and they must telephone and wait, which causes great trauma. Patients have always received medical cards when terminally ill. The whole situation has become top-heavy with officials and there are not enough front line services.

I see from the figures the mental health budget is 5.3% of the total health budget. That is a scandalously low priority. I am not blaming this Government alone as I blame the last Government also. I pay tribute to the services at St. Teresa's Hospital, Clogheen, as well as those at Carrick-on-Suir, St. Patrick's at Cashel and St. Anthony's at Clonmel. I pay tribute to Sr. Áine at Clogheen and Ms Mary Prendergast at Cashel as well as to their excellent staffs.

There were rumours St. Anthony's was to be closed and the next thing beds were gone from St. Patrick's and then services at Carrick-on-Suir had been cut. An official came out from the health board to tell the management of a hospital of the finest quality at Clogheen that five beds must be cut because there was an overspend in Clonmel, in spite of the fact Clogheen was under budget. I know the answer they got from Sr. Áine, rightly so. Some of these officials need to get more answers of that kind because they are playing with people's lives. They are playing on the fears and worries of elderly people who have served this country well and need a bit of comfort in their last days.

These people should not have to be worried by the statement issued by the Minister and his people to the effect that so many nursing home beds are being taken out of the system. We must be careful. The last Deputy mentioned careless words and hysteria but these come mainly as leaks from the Department which is playing an old game, claiming it needs to make another report. Another team will arrive in Clonmel, Wexford, or wherever, and there will be another report. They are all reports about nothing. Much ado about nothing is the situation.

However, crucial services are needed and must be allowed. The attack now is on front-line services. The name of Dr. Brook has been mentioned in this Chamber every day this week. I do not believe that an eminent man in his position, who claims to be, or to have been, a member of the Minister of State's party, which is his own business, would make such serious statements without there being some credence to them. If there were not, and he were to do something of that kind, he would not be in his job.

What is happening in south Tipperary in respect of St. Michael's unit is a travesty. In Wexford people have psychotic attacks, as they do in Tipperary and every place else, but the ambulances are now flat out on the road ferrying the patients to Waterford and there are none to pick up patients who are sick. That is a fact. We went to Wexford to see a situation and we saw it. I thank the Minister for that opportunity. However, it is only a fledgling situation, newly built and not proven. We will not have the ambulances and gardaí will not have the time to bring people to hospital when they need to go. This will not work. We had solid commitments there would be no removal of services from St. Michael's until all aspects of community care were in place. They are not yet there on the ground.

This is a situation of confidence. A budget which has only 5.3% dedicated to mental health is inadequate. This plan will not happen. We cannot trust - this is not personally meant for the Minister of State - the statements that come from the HSE through the Minister because, unfortunately, that organisation does not respect the Minister and his people. Its members think they are bigger than Ministers and the elected Government. That is the problem and has been the problem for a long time. Unless it is tackled we are going nowhere. These people must be put back in their boxes and made to earn the money they are paid. They must provide value and quality for money and, above all, respect for the people.

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