John Paul Phelan (Carlow-Kilkenny, Fine Gael) | Oireachtas source

I echo many of the sentiments expressed by the previous speaker, Deputy Liam Twomey. I, too, was a Member of the Oireachtas when the HSE was established. At the time of its establishment there was considerable belief among the public as well as among Members and those who worked in the health services that there was a need to overhaul the structure of governance that existed in our health system. There was a belief that the HSE would deliver successfully on the need to overhaul these services. It is fair to say, from my perspective and from that of customers or consumers of the HSE - the people and citizens who use the service - that much of the governance structure established by the HSE has not been an improvement on what went before under the old health board system. Deputy Liam Twomey referred to the old system and how, under the health boards, people were more empowered to make decisions locally. They had perhaps a better knowledge of the individual circumstances in which individual users of the health service found themselves.

On the establishment of the HSE, that power was removed. There was also a removal not just of oversight by the Oireachtas, but of the ability of Members to obtain information for people. The fact that public representatives deal with individual queries of constituents is much maligned but it is a reality that we are an interface between all aspects of the public service and the public. I have found the HSE structure to be most difficult to get information from for ordinary users of the health service. In fact, it is perhaps the single most positive step in the Bill that it makes the HSE accountable through the Secretary General of the Department of Health to the Minister for Health. It is a step which was committed to in advance of the last election and subsequently in the programme for Government. It is now being delivered in the legislation.

I agree with Deputy Liam Twomey about the continuous change which occurred in the early years of the HSE. Quite often, users of the service as well as staff on the front line felt that the management structures and systems which were put in place were unclear. I welcome the initiative in the legislation establishing directorates under clear headings and the creation of a direct chain of command, for want of a better term, regarding their operation. The HSE is a mammoth organisation in which approximately 100,000 people still work and has been a by-word for bad governance, politically and administratively, since its establishment. I welcome the provision in the Bill for an audit committee. It is imperative that public funds are fully accounted for when used. It is one of the great failures of the HSE as established by Deputy Micheál Martin when he was Minister that many promised savings and efficiencies were not delivered. There was quite often duplication of services across the country. Much of what was promised did not happen because of the system that was put in place in the transition between the health boards and the HSE.

I want to make particular reference to funding for mental health, a subject to which Deputy Pat Breen referred at the conclusion of his comments. The Government has, correctly, committed to ring-fencing funding to make extra provision for mental health services. Notwithstanding the current straitened and difficult economic circumstances and the fact that his hands are tied in many respects, in particular in terms of the budget at his disposaI, I urge the Minister to ensure the funding is not only protected but actually spent on mental health services.

I welcome the legislation. It may be an interim measure, but it is certainly a step in the right direction.

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