Bernard Durkan (Kildare North, Fine Gael) | Oireachtas source

I am pleased to have an opportunity to speak on this particularly important subject matter. In the economic climate the Government inherited only a few weeks ago it quickly emerged that the Government faced the prospect of having to throw up its hands and abandoning all attempts to provide large areas of service. We inherited a health structure that clearly did not work. It is all very well to criticise the holes and pockets in the health service and its patchiness.

Over the years, experts have visited this House to opine on the best structure to run the health services. I never agreed with the view that a single health body was the appropriate model for running the health service. This approach could never work as events such as recent developments in the area of medical cards and many other areas of the health service have demonstrated without a shadow of doubt. One simply cannot run a health service based on an amorphous mass of administration for the entire country. Local knowledge is lacking, circumstances differ and an emphasis on the need to be more personal in the delivery of services is absent.

I congratulate the previous and current Ministers for Health on tackling the health service. While the problems have not yet been resolved to their satisfaction or ours, changes are taking place and a new structure will emerge. I hope the types of things that occurred in the past will not be repeated. We were going around in circles as we tried to deliver a health service to citizens who were crying out for services. Individual cases were not dealt with in a personalised fashion and people felt as if they were numbers on a board. The classic example was the medical card issue that arose in the past year. This problem should never have arisen and I am pleased to note the changes taking place in this regard.

I am also mindful that the health service had to do more work with less money in recent years. This is a difficult task and I do not know how it was intended that it should be done. It is fine to criticise the inability of the Government to deliver serious and demanding services on which expenditure is required when there is no money available. The same people will declare that we must tax the rich. I would like to find out who the rich are and I assume they must be Members of this House. If that is the income that is to be chased after, we need to know where we are going. It is all very easy to produce answers when sitting around having a cosy chat. It is a different kettle of fish, however, when one must deliver the goods and raise money by imposing the taxation required to deliver the quality of service we need.

Health services have always been demand driven and demand is ever increasing. This must be recognised when we speak of remedies because the solutions will cost a great deal. Like many other Deputies, I was a long time member of one of the health boards in a previous incarnation. We learned the basics on the health boards and one of the basic facts was that one got down to the nitty-gritty and knew exactly what everything cost. Government and Opposition representatives had this information, which meant the matter was in their own hands and they could what they liked. However, they also knew that they had ultimate responsibility.

I welcome the current budget. It is an improvement and I hope it is successful in delivering an improved quality of service. I also hope we have found the formula to replace the HSE because the current structure has never worked. My colleague, Deputy Billy Kelleher, would no doubt argue that it was never given a chance to work. I was a Deputy when the previous health board structure was abolished because it was not working. The HSE could not work and will never work. I am glad the Government, in difficult circumstances, has taken upon itself the task of restructuring the health service and has provided the money to achieve it.

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