Frank Feighan (Roscommon-South Leitrim, Fine Gael) | Oireachtas source

I welcome the opportunity to contribute to the debate on the Health Service Executive (Financial Matters) Bill. Under the Health Act 2004 the Health Service Executive has its own Vote and is funded directly by the Exchequer separately from the Department of Health. Effectively, this Bill will lead to the disestablishment of the HSE Vote and put in place a new statutory framework to govern the executive's expenditure.

On occasion I have congratulated the leader of Fianna Fáil, Deputy Martin, for certain actions he took but I also hold him responsible for establishment of the HSE. One innovative item of legislation he introduced, as Minister, was that which introduced the smoking ban. That legislation was introduced in the face of lobbying by publicans and others. Deputy Martin showed courage in introducing that innovative legislation which has certainly led to lives being saved. His timing was perfect because the smoking ban was introduced at the beginning of summer and smokers did not mind going outside to smoke in the good weather. I have always been of the view that if it had been introduced in November or December, there would have been much more opposition because smokers would have objected to being obliged to go outside in the freezing cold. Needless to say, the relevant legislation was necessary, innovative and welcome and it helped to save lives.

When he was Minister, Deputy Martin made a huge mistake by facilitating the establishment of the HSE because this effectively led to power being taken out of the hands of elected representatives and placed in those of people who were answerable to no one. The question that was asked in this regard was "How much is enough?" and the answer always was "A little more". In recent years the current Minister has introduced very innovative legislation designed to try to clean up the mess that was created. When he was Minister, Deputy Martin oversaw a process whereby 147 different reports were compiled in respect of the health service. If issues arose in respect of the health service during its time in office, the previous Administration invariably commissioned very expensive reports, which took time to compile and many of which were cumbersome, in respect of them. Those reports were then placed on the shelf and those then in government stated that they would have eventually done something about them. The reports in question were left to gather dust and nothing was ever going to be done about them. That was the way the previous Government operated. It did some good things but, unfortunately, it also did many bad things. When good news emerged, it wanted to claim the credit. When there was bad news, however, it hid behind the HSE.

In the past if one wanted to get someone a bed in a hospital, one was advised not to approach a politician or go through the system. One's local doctor or a consultant in the area would probably have known somebody who could get one a bed. Effectively, those people were answerable to no one. Consultants in hospitals were able to give people beds. I know of people who handed over a few punts or euro, depending on when the incident occurred, and their mothers or whomever were kept in hospital for an extra five or seven days. That would not happen in any other country's health system. It was both wrong and corrupt. Neither the HSE nor the then Government did anything about it. I accept that not everything in the garden is rosy but at least action is now being taken.

Deputy Higgins was correct in what he said with regard to health insurance. My mother went into Sligo Hospital for a routine operation and was kept there for five days. The only reason for this was that she has private health insurance. If she had been a public patient, she would have been discharged much more quickly. She should have been taken in, treated and discharged within a day in any event. I raised this matter with the Minister. I am convinced that the hospital was following the money. My mother has private health insurance and the hospital was convinced that her insurer would just pay for her stay without question.

That is not the way to run a business.

I am pleased that at last the insurance industry is asking for proof - such as a photograph - that a bed was occupied. This may be regarded as intrusive by some but it is a way of following the money. The health insurance premium for my mother and myself has increased but thankfully I think we can afford it. I have an insurance policy but I would not want to be moved ahead of someone on a public waiting list because it is not fair. The Minister has a significant challenge to address the very complicated issues of risk equalisation.

I refer to the situation in the west. Roscommon hospital is a small hospital which needed to recruit consultants, doctors and nurses to work in that single entity. However, when the throughput of patients is not high, no doctor who wants accreditation or to move up the professional line will be attracted to work in small hospitals such as those at Roscommon or Ballinasloe. I commend Bill Maher for administering the Galway hospital group which includes Roscommon, Ballinasloe, two Galway hospitals, Sligo, Letterkenny and Castlebar. For example, a heart attack patient or a person seriously injured in a traffic accident will be brought to an accident and emergency department with a throughput of patients. Roscommon, Portiuncula and other hospitals will provide services such as endoscopy and people will come from Dublin and Galway to Roscommon where there is plenty of parking. They will be seen and out in a few hours and they will be well treated. I know of constituents on a waiting list in Sligo for the treatment of varicose veins who had to wait for treatment for nine months. I have suggested to them to try Roscommon hospital which has a waiting list of less then three weeks for the same treatment.

I support the establishment of hospital groups. In the past a consultant would be based in Galway and would visit Roscommon once a week. After six months the consultant would decide that he could not be bothered going to Roscommon and that the poor unfortunates in Roscommon could come to him in Galway. Under the new arrangements, consultants and other medical staff will be required to be in Galway for two days and a day each in Sligo and Roscommon. I commend the arrangement whereby doctors and professional staff can work on a rota between the hospitals in the group.

Health is a very emotive issue. I wish to pay tribute to the nurses and doctors for their work which is often difficult. However, in many cases such as this, the fight is never what the fight is about; it can be a disagreement about overtime or promotions, for example. These issues can impede a solution of the main issue. Much has been achieved with a budget which has been decreased by 20%, with 10% fewer staff and an 8% increase in population. We have to make that money go further.

Fianna Fáil when in government built an accident and emergency department in Roscommon hospital at a cost of €7 million. However, Fianna Fáil when in government also set up HIQA which closed it down. We must ensure the money is well spent and that patient safety is at the forefront. I will hold the Minister to account if patient safety is undermined but I compliment him on his work so far.

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