Joe McHugh (Donegal North East, Fine Gael) | Oireachtas source

At the outset I welcome the Minister of State, Deputy White, and congratulate him on his new role. I wish him well and no doubt his good wife will keep him right from a social consciousness perspective. As a former lecturer in sociology in Maynooth, she certainly has an in-depth knowledge of the social needs of the country. Every opportunity for the Minister of State to hear interventions from colleagues will be used. There is no better opportunity than a technical Bill like this for that, as we have the liberty to digress.

With regard to the recognition of qualifications, a parallel could be drawn with the Department of Education and Skills, which oversees the Teaching Council of Ireland. The Department of Health will have a system in place for qualifications outside the jurisdictions to be recognised in this country. I wish the Minister of State well with the process, and it is important for the Department to consult with those involved with the Teaching Council of Ireland to see what they have learned over a number of years. Some 12 months ago in this House I was critical of the teaching council but since then, with a backdrop of fewer resources and considerably fewer human resources in the council, there has been a marked improvement. Its systems took a while to put in place correctly but the council has done remarkably well in the past 12 months. It should be acknowledged when something works well and there should be credit where it is due. I acknowledge the work of the Teaching Council of Ireland.

We should add paramedics to the list of professions to be recognised, and I have spoken to a few of them with American qualifications who would be interested in different roles within the Irish system. Their qualifications are not recognised so it is important we check that out.

The patient mobility directive is due to be transposed into law in October 2013. With that in mind there will be great changes, and I would like the Minister of State to intervene so we can get a good understanding of what is coming down the track. This is not just about a cross-Border process between Northern Ireland and the Republic but rather a European directive that will enable patients to get care in different countries throughout the European Union. That will be a historic feature and landmark change to the way we deliver health services within the Union. I note the existing international work that is ongoing between the United Kingdom and Ireland, including lung transplants in London or the Duchenne muscular dystrophy treatment of young boys in Newcastle in the UK.

There has been an historical movement of patients across the UK, Ireland and Europe so it would be important to learn from the experience, including that of the young boys who suffer from Duchenne muscular dystrophy. Currently they are registered through the HSE and in the past they had travel paid for. That has now changed, which puts pressure and cost on the young boys travelling to Newcastle.

However, the more important point is not an economic one. The parents of the boys currently going to Newcastle are of the opinion that the standard of care and service they get in Newcastle would not be provided in this jurisdiction. I ask the Minister of State to familiarise himself with the issue. I realise it is a clinical one and that he is focused on the primary care aspect, but there will be an overlap because there is a degree of primary care at a household level for boys who suffer from Duchenne muscular dystrophy, a disease that shortens considerably the lifespan of these boys. However, on a positive note, the ongoing clinical trials in Newcastle are reassuring to the parents and they have advanced many new treatments. It is important to emphasise the fact that if a service is being provided in the UK or elsewhere in the European Union, people have the choice to access it.

I take this opportunity when the Minister of State is present to raise a primary care issue. There is grave concern about the home help service about which no doubt he will be aware from his Labour Party colleagues. The time of year is a factor as we approach the winter. Many elderly people are used to receiving the assistance of a home help, be it for an hour a day to help them get up in the morning. Any change in respect of this service must be treated delicately and sensitively.

An 87 year old who comes to my clinic on Monday told me that she has the assistance of a home help for one hour a day, five days a week, Monday to Friday, and in that way does not incur the extra cost of a double time payment for a home help on a Saturday and Sunday. She would be agreeable to have assistance for half an hour a day and she also proposed she does not need assistance in the summer time. This 87 year old woman has come up with solutions. She can make savings and realises where savings can be made. Any sort of review of decisions in respect of the home help service must be taken on merit and it is important to listen to the voices of the people who receive this service.

A consultant got in touch with me with respect to cross-Border challenges. While we as legislators and politicians talk about the potential for cross-Border collaboration and synergies to provide services rather than incurring duplication in the provision of services, there is a cultural barrier, with which no doubt the Minister of State will be faced in the not too distant future, in that there is resistance to change at all levels within the health service. It will require strong leadership and hard decisions to ensure there is collaboration and positive co-operation at a cross-Border level.

I want to make a point regarding the new politics of Sinn Féin and Fianna Fáil with respect to representations at a political level, not only within the health service but across the board. As a Deputy representing my constituency, having been involved in politics for 12 years at council level and previously as a Member of the Seanad, I am at a loss to know as to how far representation can go. For example, in the case of rural Garda stations, am I allowed to lobby the Minister to retain Garda stations in Donegal or is that a prerogative of the Commissioner? Is it a civil servant diktat list system to which we as politicians in this House must adhere? Are we allowed to make representations? Where does the politics of Government party Deputies such as myself in terms of my constituency come into play?

I wish to cite another example, that of Malin Head Coast Guard station, and I am digressing from health but this is an important example. Prior to the formation of this Government, Deloitte & Touche was commissioned by the Department of Transport seven years ago to prepare a report examining the centralisation of coastguard facilities in the country. When this Government came into office, that Department commissioned another report, the Fisher report, calling for the centralisation of coastguard services. We have to examine where we are at as a political body and whether interventions can be made by politicians to ensure constituencies such as mine get the services the people demand. I have met the Minister, Deputy Varadkar, and will continue to lobby him to ensure the Coast Guard stations remain in Malin Head and Valentia, even though the new politics of Sinn Féin and Fianna Fáil are more or less insisting there should not be interference from politicians in regard to diktats from civil servants or lists that are drawn up. While acknowledging that the world is not perfect, the issue of what powers politicians have to represent their constituencies is a legitimate one that should be explored in this House. Top civil servants remain in office after a Government falls - there was a car crash in terms of the loss of Fianna Fáil politicians in the last general election - and they retain their same doctrines and philosophies. It is our job as politicians, in the interests of the people in our respective constituencies, to challenge whatever diktats or list systems are presented to us.

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