Bernard Durkan (Kildare North, Fine Gael)

I am pleased to have the opportunity to speak on this Bill. I note in particular the comments of my colleague, Deputy Andrew Doyle. If an analogy is to be drawn and lessons are to be learned on how to run services, surely the maternity services are the appropriate comparator. These services cannot be postponed. One cannot be put on a waiting list for births. They must take place whether we like it or not and they must be provided for. This should be the hallmark of all the heath services provided in the country and the sooner we recognise this, the better. Certain services must be provided at a given time with very little variation in time and these must be provided regardless and in the best possible surrounding and circumstances.

The introduction of this Bill is rather interesting, although I am unsure why the issue must be dealt with by way of primary legislation. I understand legal issues could arise due to the lack of legislation.

This service, like all others, must be a service of quality and reliability. It must be state of the art and a centre of excellence service and nothing else is acceptable. Numerous infections and diseases are blood borne and the number of occurrences of these infections increases from time to time and when people travel from here to elsewhere and from elsewhere to here. This brings new risks. I would like to be assured that the service will be updated and upgraded in line with requirements on an ongoing basis. Over the past number of years there has been quite a lot of criticism of the Irish Blood Transfusion Service. Many dedicated people have worked in that service over the years and have suffered as a result of the criticism that resulted from an aberration, which may have been temporary, but which gave rise to difficulties that should not have arisen. If we ran the service as it should have been run, there would have been no difficulties. We need to ensure we maintain traceability, accountability, high quality and standards and that these criteria are universally applied to the service, whether in the macro or major sense. The proposed legislation should be of significant benefit to the provision of an important service throughout the country.

I hope that when the service is set up, it will have access to the highest quality and standard of international research. Without this access, we remain in a bubble of our own and we can no longer afford that. Over the years, I have repeatedly raised questions in the House on the access to scientific advancements and statistics. These are hugely important if we are to evaluate the degree to which we have the capability to meet requirements now and in the future. One of the failures of the health service over the years is the degree to which we have been incapable of projecting and predicting what is required, even a couple of years down the road and, more particularly, for the mid-term. It is for that reason we have the ridiculous situation of having long waiting lists. I cannot understand why we have waiting lists for services.

It is just as easy to do this right at the beginning. It is just as easy to do it quickly and just as easy to do it now rather than tomorrow, next week, next year or never. I raised this question with a number of people in the HSE recently when they addressed us in Leinster House. They admitted the lack of statistical information. I cannot believe that a vital service like health services should have a lack of statistics. By measuring the statistics from time to time, one can get a clear impression of how issues are being dealt with and what the likely requirement for the future will be. Equally important, one gets an impression of the quality and standard of service required for the future. All of the lessons we have had to learn from events over the past ten or 15 years here have pointed up these areas as ones needing improvement, but I cannot understand how this came about in an era when we aspired to centres of excellence. I hope this service will be a centre of excellence and that we will not need to look at it again five or ten years down the road because it did not work out the way we thought it would.

Deputy Andrew Doyle drew attention to the issue of possible savings. I am aware the savings projected will not be achieved now because of unpredicted increased usage. This illustrates once again the need for statistics. This usage should not be unpredicted, especially over a three-year period. It should be quite simple to make the predictions. Any requirements in any area as sensitive as the health services should not be unexpected. I do not want to go over the various problems that have existed in this country over the past ten or 15 years, such as failure to read X-rays properly, failure to diagnose properly, failure to examine diagnoses properly and a general failure to provide the quality and standard of health service in keeping with the modern era, regardless of our aspirations. There are and remain a significant number of dedicated people in the health services committed to the highest quality and standard of service throughout the service. Unfortunately however, there have been a number of glitches. We hope that in a sensitive area like blood transfusion or, as in this case, coagulants, we have eliminated any such possibilities.

We need to take another look at the centres of excellence. Hopefully, this Bill will give rise to a centre of excellence in St. James's Hospital. All centres should be centres of excellence. All of the services we provide should be top class services. There is no excuse for having second class services. It is dangerous to have anything other than state-of-the-art, first class services in the health services, because the weakest link becomes the common denominator and brings everything down to that level. Like Murphy's law that is what will happen. We should be warned from our experiences in the past of that.

It is necessary to have major debates in this House on the health services. If there is one issue with which the public gets frustrated, it is the health services. On a daily basis we are told we must have long delays and waiting lists. These are simple issues that only require good management. There are more managers involved in the health services now than ever before. We had a huge increase in the numbers employed in the health services over the past ten years, but now we are seeing a huge reduction in numbers. The question arises now as to whether we can continue to provide the same quality of service and whether we can improve the quality of service. There is a question as to whether we can change the structures to try to ensure that accountability and quality are provided in such a way as to provide the public, which elects us, with the service they require. We are not talking about a service they demand, but one they require. I do not wish to go into the issues that come to mind in this regard.

The product selection and monitoring advisory board has a wide remit and covers this area. It must advise the contract holder on national product requirements and the product surveyor on how to meet requirements. This is where research comes in. There must be access to international and scientific research and state-of-the-art advancements. It is simple to do this. We should not necessarily be reliant on product based information. We should have access to independent research alongside research associated with the product. Advice must be available to the contract holder on the selection and monitoring of products, including advice on product delivery and distribution and taking account of national and EU procurement product regulatory and licensing laws.

We must take a deep breath in this country when we talk about regulation, but it is important. However, it is the enforcement and recognition of the standards laid out in the regulations that are most important. If we do not recognise the necessity to keep to the standards, the standards mean nothing. Again, we are only as good as our weakest link. I know the Minister of State will have answers on these issues in her response. I do not suggest for a moment that any of the issues I have raised relate to the Minister or the Minister of State. These are issues that have arisen in this House over the past ten years and from which we have learned harsh and bitter lessons. As time goes by we should learn from each of those lessons and make sure the same mistake is not made again. We must not repeat our mistakes.

We need to comply with the EU regulations to which other speakers have referred. I hope that will be done. From time to time I submit parliamentary questions probing compliance with various national and EU standards. The information I get is often rather vague. I will repeat to the Government what I often said to Ministers when I stood on the opposition side of the House. Ministers must have available to them the highest quality of information regarding product reliability. The quality of replies to parliamentary questions must be high. This is a serious issue. When a Member submits a parliamentary question on any issue, that Member is entitled to a reply, because the public are entitled to a reply. We must be open and accountable. The public must be able to say a process is working properly and can be relied on if the Minister says so. When you and I first came into the House, a Leas-Cheann Comhairle, a huge degree of reliability was placed on the word of a Minister in a reply to a parliamentary question. I am not sure that has improved over the years. It is hugely important to the Government, the Opposition and the country to restore that confidence.

It is equally important for a Minister to be able to stand over the information he or she gives to the House. There should not be a vague area or mistakes. There should not be a need for a subsequent apology. It should not arise. I am sure this issue is being correctly addressed at present. I do not mean to reflect on personnel, present or past, but the question must be raised. If this matter is dealt with it will be of considerable importance to the wider community outside the House.

I have referred to statistics. The Bill will require the contract holder to be advised on national and international trends in respect of product safety, including reported incidents of adverse reactions, efficacy, quality and supply. We must be absolutely certain we can rely on available scientific information. It is quite simple to follow up on all these issues, to converse with our colleagues in other jurisdictions and, through modern technology, to get the information almost instantly. Before the introduction of modern technology it was much easier to get information. Colleagues on all sides of the House will recognise this. Many Deputies have been members of local authorities or health boards. In my time on such bodies, it was possible to access any information on file within 30 seconds or one minute. That can no longer be done. Nowadays, if one seeks what are called old files, one finds they have been transferred to microfiche and the information they contain cannot be made available for two or three weeks. I can hardly believe that.

Over the years, I have been repeatedly told in replies to parliamentary questions that the statistics I require are not retained by the Department concerned. That should not be the case. All statistics relevant to all possibilities related to running the health service should be available to the Minister. Otherwise, the Minister will have difficulty providing information to Members of the House and to the general public and creating the sort of structures the public deserve, particularly in relation to a life affecting service.

I welcome this development. I hope it puts in place something we can rely on in the future. I have no doubt of the commitment of the Minister and of those providing the service. It is, however, important to realise that we live in changing times. Demands and standards change from time to time, and sometimes overnight. It is hugely important that a service develops in a way that allows it to identify new requirements long before the need arises. That is good projection and good management. It is how health services must be managed in the future.

In the near future, I hope we can have an unlimited debate on the delivery of this vital service to people who depend on it and that it will deliver ever increasing efficacy, reliability and safety in the future.

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