Simon Harris (Wicklow, Fine Gael) | Oireachtas source

With this Bill, we take another firm step towards abolishing the HSE, on the basis of which the Government campaigned in the last general election. However, we cannot do the populist thing of abolishing the HSE in the morning and leaving a vacuum. The untangling of the bureaucratic mess that is the HSE must be done in stages, in a logical manner and over time. This is exactly what the Minister for Health, Deputy Reilly, has set out to do. Many Members and the media are so used to successive health Ministers failing and not delivering that everyone is ready to jump on every possible criticism of the Minister, Deputy Reilly, to claim he is not delivering. Tonight, we have concrete evidence of a further step taken by the Minister and the Fine Gael-Labour Party Government to abolish the HSE and replace that bureaucratic monster with a system of directorates that prioritise important health areas.

I recall a former health Minister and leader of the Progressive Democrats referring to the catastrophe of the HSE as being solvable in nine days. It has been a very long and expensive nine days for the people. We have seen the terms "cannot get answers", "black hole", "lack of transparency" and "no accountability" attached to the HSE in the public mind. We all remember that when Deputy Martin, then the Minister for Health and Children, was asked at a meeting of the health committee by my former constituency colleague Liz McManus whether he was responsible for the health service, he shrugged his shoulders and said he was not. That image symbolises the lack of accountability at political level in the delivery of our public health service.

As a member of the Committee of Public Accounts, I see how the health service has multiple financial systems all working on a different basis. When HSE officials attend the committee, what seem to be relatively simple questions are often not answered because the information simply does not exist. I recall asking how many people in the HSE earned increments above a certain level. It took weeks for the HSE to establish the answer because there was no system in place to deal with the query. Anything we can do to untangle the HSE is a vital and welcome development.

It is important to remember that our health service is not just about hospitals and trolley counts. Members and the media fall into the trap of thinking only about accident and emergency departments, when the service consists of far more than just hospitals. I am glad the new directorates that will be set up in the HSE recognise this fact. There will be directorates for hospital care, primary care, mental health, child and family care, social care and public health. We need to look at how we can treat people in their communities and provide health care at a more holistic level.

The development of the new child and family agency to prioritise child protection is very important. We know of so many instances in which the HSE did not even discuss the issue of child protection at board meetings when there were so many failings in our child protection systems. The creation of this new directorate has to be a welcome development.

It sends a message from the Oireachtas and the Government that when we hold a children's rights referendum, it is more than simply a referendum or a box-ticking exercise because it is being backed up with real and substantive policy change.

I welcome the fact that we will have a new directorate specifically empowered in the area of mental health. It was decidedly disappointing that the House and the Government, through the budget, could propose to ring fence €35 million, that the Oireachtas could vote that resolution through, that the Minister of State with responsibility in the area could declare in good faith on the Front Bench on this side of the House during a Topical Issues debate that she had the money in her back pocket, but then unelected HSE officials could manage to siphon off that money and put it somewhere where the Minister did not want it, where the Government did not intend it and where the Oireachtas did not vote it. If we are serious about real health reform and real political accountability then when the House takes a decision, when the Government puts forward a proposal that is accepted and when a Minister directs something to happen, we cannot allow a bureaucratic structure to do something else.

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