Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

Deputy Lisa Chambers and I have tabled amendments Nos. 5, 9 and 20 in this grouping. They refer specifically to the need for the Minister for Health to seek the consent of the Minister for Finance and the Minister for Public Expenditure and Reform, should he or she wish to make any order or regulation. Section 75A relates to the sitting Minister for Health being able to make arrangements. It reads:

The Minister may, with the consent of the Minister for Finance and the Minister for Public Expenditure and Reform, make such order or orders as he or she considers necessary to continue in being or carry out any reciprocal or other arrangements in relation to health services which were in operation between the State and the United Kingdom immediately before the withdrawal of the United Kingdom from membership of the European Union.

Section 75B essentially says the same thing with regard to regulations.

Obviously there is a relatively complex and important set of relationships between Ireland and the United Kingdom in the realm of health care, whether that be using Altnagelvin Area Hospital in Derry or ambulance services moving north and south of the Border. In fact, the vast majority of cross-Border ambulance traffic comprises ambulances from Northern Ireland responding to emergency calls in the South and bringing citizens of the Republic to hospital. We also have the cross-border directive and the treatment abroad scheme. The relationship is very complex and the issues involved are very important. There are many people throughout this country who are waiting to have surgery carried out in one of the larger UK hospitals or waiting for UK doctors to come here to provide, for example, some very specialised paediatric services. Highly specialised surgeons and their teams regularly come from UK hospitals and spend a day or more in Irish hospitals, operating on patients.

My concern is that the sitting Minister for Health may need to be able to make quick decisions. Let us say a surgeon and his or her team are coming over to Crumlin hospital for two days of operations but something pops up. We will be living in a world of unintended consequences and complexities, not all of which we are able to foresee.

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Some order is required from the sitting Minister for Health to make sure the team can come in, that the insurance policies are covered, to make sure the drugs they use are sanctioned and so on: it is a complex legal field. The way that 75A and 75B are written provide that any order, arrangement or regulation from the Minister for Health all require the consent of the Minister for Finance and the Minister for Public Expenditure and Reform, currently held as one post, but after a reshuffle or a general election the roles could quite easily be back to two different posts.

I have two concerns. The first is that it slows things down and it does not allow the Minister for Health of the day make the decisions that he or she is entrusted by the Taoiseach to make. My second concern is on a democratic point. I do not believe it is appropriate that a Cabinet Minister should seek consent of the Minister for Finance.

I have tabled three amendments that say, very specifically, consent is required from the Minister for Finance when the issue relates to taxation, and that consent is required from the Minister for Public Expenditure and Reform where there is an expenditure implication of the order. For taxation and expenditure it would be yes, but for everything else I do not believe it would be appropriate for a Minister for Finance to have that authority. It is not what they are doing day to day: they are not immersed in the world of healthcare.

I hope the Minister will accept the amendments. They are modest but important in making sure the Minister for Health of the day can move with the necessary speed. Sometimes these situations can move very fast. A surgeon and his or her team could be sitting in an airport ready to come to Ireland, or on arriving in Our Lady's Hospital for Sick Children in Crumlin they may need support from the sitting Minister. There is no reason why any Ministers for Finance or Public Expenditure and Reform should be involved, unless there are taxation or expenditure issues, in which case the amendments cover both of those. I hope the Minister will support the amendments.

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