Charlie McConalogue (Donegal North East, Fianna Fail) | Oireachtas source

I support Deputy Kelleher in introducing this crucial motion. I do not wish in any way to personalise this because that is not what the public is looking for, nor is it what any of us in this House wishes to do. Health at any time is one of the most essential services to which citizens need access. At a time when we are facing cuts in our budget the Government's number one priority must be to ensure that services are protected. Up to 18 months ago the Minister was on that side of the House as the Opposition spokesperson on health. He talked the talk in terms of what he would do if he became Minister. Along with his now Government colleagues, he made several promises about what they would do if the public elected them to office. Memorably during the general election, the Taoiseach stood in front of a campaign meeting on a street in Roscommon and promised that, should he be elected to office, there would be no change in the status of the emergency department in that town's hospital. We have seen where that promise has gone. We have also seen what has happened to the stance the Minister held when in opposition.

The Fine Gael Party promised universal health insurance were it elected to office. Instead, 55,000 people gave up private health insurance last year and are now dependent totally on the public health system. Instead of the reforms the Minister promised, with money following the patient, hospitals across the country are being asked to make cuts regardless of how efficient they are or the number of treatments they carry out.

On coming into office, one of the Minister's first actions was to abolish the HSE board. That was followed by the CEO moving on and being replaced by someone of the Minister's choosing. One of the problems with the lack of progress in reform of the health service is, unfortunately, the Minister's leadership. That has never been more apparent than when some of his ministerial colleagues, including his departmental colleagues, refused to express confidence in him. A year and a half into government and with three and a half years left in the most crucial portfolio, colleagues are failing to express the faith in him that he requires in order to carry out the types of reforms that are needed. Unfortunately, the only option is this motion of no confidence and for the Minister to consider whether he will be in a position to continue in this role and deliver the reform and change that is needed.

The HSE was asked to put together a service plan for this year which we did not see until the end of January. Then the HSE regions were asked to put together regional health plans which were not signed off until the middle of March. How are we supposed to be able to plan a health service for a year when the plans for the service itself are not agreed until half way through the year? When the Minister prepared the budget in December he premised it on many things which he was then unable to achieve and did not follow through on. The was supposed to be a saving of €124 million through a new pricing agreement with the industry. Unfortunately, in June, this was described as unachievable by the outgoing HSE CEO, Mr. Cathal Magee.

It was also assumed that there would be an additional €140 million saving from increased private income but that assumption was described as undeliverable by Mr. Cathal Magee in June. Reducing agency costs by 50% was a further target which was again described as unrealistic by the former HSE CEO. Given that the budget introduced by the Minister in December was based on figures that were unachievable, by half way through the year the HSE was facing an end-of-year deficit of €500 million. What was the Minister's reaction to that? Instead of taking leadership of the HSE, the board of which he had abolished, the Minister's reaction was to send the HSE's officers out to announce cuts a few weeks ago while he went into hiding as opposed to taking responsibility. Unfortunately, that was a reflection of our health policy in the past year and a half under the Minister's stewardship. This was followed by members of the Government coming out and saying they were unaware of the cuts and in many instances refusing to express confidence in the Minister for Health. How does he plan to continue to provide the leadership to deliver the reform we require given the situation in which he finds himself now?

I would like to outline the type of reform that is required in the region I know best and, in particular, in the hospital I know best, Letterkenny General Hospital, where we have seen real examples of the Minister's failure to introduce a policy whereby money follows the patient. Its spending has gone from €105 million two years ago to a budget as required by the Minister of €92 million this year. That takes no account of the number of treatments carried out or how efficient the hospital is or the impact any cuts the Minister might bring in will have on services. However, other hospitals, which might not end up being nearly as efficient, are being asked to cut their budgets by similar amounts. These are hospitals that may have capacity. No realistic review of what is being delivered for the money being put into the service is being carried out. There is no correlation between the funding cuts requested by the Minister and the treatments that may be delivered on the ground.

The Minister took over leadership of the HSE and got rid of the board which was responsible for it in the past. Yet he seems to have lost the ability to lead and the confidence of his colleagues to do the very important job of delivering real health service reform.

It is time the Minister reconsidered his position and that the Government reconsidered what type of leadership is needed to deliver the type of health service required by the people.

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