Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I move:

That Dáil Éireann has no confidence in the Minister for Health, James Reilly T.D., because of his inability to deliver on his budget commitments which were based on false and misleading targets in many areas that were never achievable or implementable due to his lack of governance, resulting in more chaos across the health service which will directly impact on patients because of more frontline services being cut, extra bed closures, and more cuts to social support services to the disabled and elderly.

I do not particularly like tabling motions of no confidence in Ministers. Over the years, I have seen them get very personalised, sometimes deflecting from the reality of what a motion of no confidence is trying to achieve. I do not expect theatrics or drama tomorrow night, with Deputies crossing the floor to support our motion of no confidence in Deputy James Reilly, but I would be failing in my duty as an Opposition Deputy not to highlight his failings during his tenure as Minister for Health.

The Minister is no longer on the back of a truck in some rural town promising the people the sun, moon and stars. He is the Minister for Health and he has a responsibility. His actions and deeds to date have indicated that the majority of people in this House do not have confidence in him to carry out his duties. Since the Minister was appointed in 2011, we have had dysfunction and chaos reigning in the Department of Health. The HSE under his stewardship is being dismantled effectively and slowly so it is incapable of delivering the health service the people expect.

I want to keep this to the points of principle and have a fair debate on what this motion of no confidence is about: highlighting the failings of the Minister for Health in addressing the serious challenges the health service will face in the months and years ahead. The Minister came to power saying he had a mandate for reform and for changing how health services are delivered. Unfortunately, that mandate was sought under false pretences. It was sought using promises to people in Roscommon that the accident and emergency department would remain open and using promises to people in Monaghan and the north east that a new hospital would be built before there was any downgrading of services in Navan, Drogheda or Dundalk. It was sought using promises to the people of Cork that orthopaedic services would not be moved from St. Mary's Hospital and that the Minister would cut consultants' pay and abolish prescription charges. Those are just a few of the promises the Minister made, and I am sure as time goes on that many more of those commitments made on the backs of trucks throughout the country will come to light.

Clearly now, however, we face chaos and crisis in the Department of Health and the health service in general. This time last year, the Minister started running around the corridors of power telling everyone and anyone who would listen that we faced doomsday if he did not get his way when it came to delivering a budget for the health services for 2012. He put fear into his colleagues but at the end of the day he did not have the support of Cabinet to bring forward a budget that would be sustainable. The budget in December 2011 for this year was dishonest at the very least. He cobbled a budget together, with figures and statistics, savings that could be achieved, legislation that would introduce price referencing, generic substitution, the charging of private insurers for the full cost of public beds and the reduction of agency costs, but none of this has happened. As long ago as last March, the Minister was warned by the then CEO of the HSE, Cathal Magee, that the budget he had delivered was no longer sustainable. The Minister did not listen and we now have a situation where only a couple of weeks ago, because of his incompetence and inability to deliver and manage a budget, there were people outside Government Buildings protesting because their personal assistants were being withdrawn. Home help hours and home care packages were being withdrawn.

That is the context for this motion of no confidence. I do not do it lightly. Our party thought about this long and hard. We would be failing in our duty to highlight the Minister's failings and the damage and the impact his inability to manage the health service and the reforms he proposed are having on people.

There are two Ministers of State in the Department of Health, Deputies Róisín Shortall and Kathleen Lynch. This evening or tomorrow they will come in and swear allegiance to the Minister and promise they have a working relationship with him. It is quite evident that there is bedlam in the Department and no functioning working relationship between the Minister and the Ministers of State. We are unsure if the Minister delegated functions to the Ministers of State and gave them specific areas of responsibility. A report by Sarah McInerney in The Sunday Times was headlined "Reilly and Shortall's fractious working relationship revealed in a series of angry letters". It is quite amazing this is happening in the Department of Health when the Minister has promised there will be reform, with structures being put in place to streamline the health service.

One of the basic promises the Minister made related to primary health care and its roll-out. The Minister of State who was meant to be responsible stated clearly she had no responsibility in this area and that the Minister was undermining her budgets by taking money from ring-fenced budgets without even informing her. Unless these letters are figments of someone's imagination, they show that at the heart of the decision-making process in the Department of Health, there has been a complete breakdown of trust between the Minister and the Minister of State, Deputy Shortall, and probably the other Minister of State, Deputy Kathleen Lynch. As recently as a number of days ago, the Minister of State with responsibility for mental health stated there would be no reduction in her budgets, but the Minister had already raided that budget to fund the deficit evident in the broader health services. The Minister entered office with great fanfare and promise, saying he would transform health services. Unfortunately to date, there has been nothing but dysfunction and chaos reigning in the Department itself, which has percolated down into the HSE.

I find it bizarre that the Minister was appointed 18 months ago and one of his first major announcements was that he would get rid of the 50 cent prescription charge. Some time later he rowed back on that decision. He then arrived at HSE headquarters like Wyatt Earp at the OK Corral, or perhaps in this case like Doc Holliday, to sack the board and fill it with his own appointees and Department of Health officials. That is fine and the Minister has said he now has control of the HSE, but as recently as two weeks ago, when the health cuts were made, the Minister said they were not sanctioned by Government, that they were a HSE decision and that he would overrule them after the backbenchers got a little tetchy but, more importantly, when he saw for himself outside Government Buildings the misery and angst he was causing to many of the most vulnerable in our society.

How could the Minister even contemplate sanctioning the removal of personal assistants, home care packages and home helps in the context of a €14.3 billion budget? Why did he decide those would be the first areas he would cut to rein in a deficit he should have reined in months ago when he was warned about it by the former CEO of the HSE and by Members on this side of the House? Every time we raised that, we were shouted down for scaremongering and trying to whip up fear and anger among the public. We were not. We were following what was happening and the sad reality is that last June, the former CEO put his hands up in the Committee of Public Accounts and said the budget and figures presented to the Dáil were no longer achievable and were utterly unsustainable.

Even at that late stage, five months into the year, the Minister still refused to act. The Minister for Public Expenditure and Reform implored the Minister to get his house in order and the Minister of State, Deputy Shortall, was writing letters that highlighted that she was even willing at that late stage to intervene in the discussions on generic drugs and price referencing to bring about negotiations that would save some money in 2012. The Minister, however, put his head in the sand.

While the Minister talks a great game of reform and delivery of better health services, his decisions last week and the week before that attacked the most vulnerable in our society were the most distasteful things I have seen from this Government so far.

That is the reason we decided to table a motion of no confidence in him and not because of his other difficulties. I acknowledge he may be distracted in other areas. Clearly, he sanctioned the decision and then there was the famous U-turn that was not a U-turn with the Taoiseach saying he was courageous to change his mind. It was either a U-turn or he sanctioned the cuts himself. I would like clarity on who is in charge because last year-----

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