Brian Hayes (Dublin South West, Fine Gael)
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Question 66: To ask the Minister for Health and Children if, in view of recent comments by the chief executive officer of the Health Service Executive regarding aspects of the health service, she continues to have confidence that he supports all Government health policies; and if she will make a statement on the matter. [18002/07]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I am entirely satisfied that the chief executive officer of the Health Service Executive fully supports the Government's health reform programme and I have full confidence that the Health Service Executive is implementing Government health policy.

I assume the Deputy's question was prompted by comments made by the CEO in the course of his address at a major health conference in Dublin on 12 June last. In his address Professor Drumm pointed out that, among the major areas where change is required in our health system, are the building up of primary and community services and reforming the acute hospital system. The points made by the chief executive officer are fully consistent with Government policy.

The programme for Government includes commitments to extend the GP out-of-hours service nationwide to ensure patients can be seen within one hour of their call. This will give access to on-duty GP care 24 hours a day. GPs will be fully equipped to ensure their expertise and skills minimise the need for their patients to attend an accident and emergency unit. It also includes commitments to improve GP cover by developing primary health centres in socially deprived areas; work with GPs to ensure constantly improving out-of-hours cover for patients; ensure there is a primary care team serving every community, with particular reference to new and rapidly growing areas — 500 such teams will be funded by 2011; introduce improved supports for GPs who work in remote and disadvantaged communities, both for those starting out and those already established; and continue to implement measures to ensure the availability of real alternatives to hospital for those who require lengthy convalescence.

As far as acute hospitals are concerned, the programme for Government commits to the provision of an additional 1,500 dedicated public only beds. In addition, the HSE is reviewing the acute hospital bed needs up to 2020. This review will identify the number of acute beds required and the capital and revenue implications and advise on how to meet the identified need. The findings and recommendations of this review will inform the Government's policy on developing capacity in acute hospitals into the future.

Brian Hayes (Dublin South West, Fine Gael)
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The Minister has informed the House that she is entirely satisfied with the position taken by Professor Drumm and the Health Service Executive, yet in his recent comments on the number of acute beds in the health care system Professor Drumm could not be clearer. He stated that providing more acute beds would not improve the health service or deliver greater efficiency. This position is entirely different from that of the Minister. What is the true position?

Recently, Professor Drumm also stated: "I see co-location as being a competitor for the HSE." Does the Minister agree or disagree with that comment?

Mary Harney (Dublin Mid West, Progressive Democrats)
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I totally agree with Professor Drumm regarding beds. If we had 10,000 more beds in the morning, they would not significantly improve access and patient care if they were not appropriately used. For example, the recent survey showed 13% of admissions are inappropriate and that people should not be in hospital. On the day the consultants reviewed all of the hospitals, 39% of patients should not have been in the acute hospitals.

Brian Hayes (Dublin South West, Fine Gael)
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Yet the Minister is planning 1,500 extra beds.

Mary Harney (Dublin Mid West, Progressive Democrats)
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We are planning to use the beds we have efficiently and effectively and to have quicker access times for patients. The point made by Professor Drumm — I have made it many times, both here and at the Oireachtas Committee on Health and Children — is that if we do not use the existing stock of beds more efficiently and effectively, no matter what the number of beds is, if we do not get access to diagnostics from GPs so patients do not have to be admitted to hospital to have diagnostic checks carried out, and if we do not manage chronic illness at GP level in the community, people will end up accessing hospital beds.

The decision of the HSE board to pursue co-location was made on the recommendation of Professor Drumm. Competition exists between public hospitals at present. The Deputy is a member of the board of the children's hospital in Tallaght so he does not need me to tell him how competitive it is vis-À-vis the other children's hospitals. In fact, this is one of the reasons there is such controversy attached to creating a single hospital. Competition is no bad thing between service providers, whether they are in the public sector, private sector or a mixture of both.

Brian Hayes (Dublin South West, Fine Gael)
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Interesting as the Gettysburg address is, I am simply interested in the answer to the question. I would like a "yes" or "no" answer. Professor Drumm stated: "I see co-location as being a competitor for the HSE".

Mary Harney (Dublin Mid West, Progressive Democrats)
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That is true.

Brian Hayes (Dublin South West, Fine Gael)
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Is that the Minister's position?

Mary Harney (Dublin Mid West, Progressive Democrats)
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Yes, it is.

Brian Hayes (Dublin South West, Fine Gael)
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That is the exact opposite of what she told the House yesterday, when she spoke about a unified system on the grounds of public hospitals between public and private hospitals. We have now got an admission from the Minister that she sees this competition by the new co-located hospitals against our public hospitals as in order. That is fundamentally different to what she told the House yesterday and to her stated position. Has the Minister full confidence in Professor Drumm, given that he is clearly opposed to her ideology-driven model of providing additional private beds on public lands?

Mary Harney (Dublin Mid West, Progressive Democrats)
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The Deputy is wrong. I told him the HSE board signed off on co-location on the recommendation of the CEO and the management——

Brian Hayes (Dublin South West, Fine Gael)
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It was a Government decision.

Mary Harney (Dublin Mid West, Progressive Democrats)
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No. The HSE board signed off on these projects for the individual hospitals on that recommendation. Professor Drumm put in place a process of thorough audit within the HSE in regard to each individual site to make sure——

Brian Hayes (Dublin South West, Fine Gael)
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But that——

Mary Harney (Dublin Mid West, Progressive Democrats)
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There is no point in the Deputy asking me a question if he will not listen.

Brian Hayes (Dublin South West, Fine Gael)
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The Minister will not answer.

Mary Harney (Dublin Mid West, Progressive Democrats)
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It was put in place to make sure that what was happening at each site complemented what was needed in the public hospital. There will be an element of competition. Tallaght Hospital competes with St. James's Hospital. Has the Deputy ever got into discussions with those hospitals? Consultants compete with each other even within hospitals. This is the nature of how services are provided. People compete for resources, capital investment, more consultants, more staff and more services both within and between hospitals.

Brian Hayes (Dublin South West, Fine Gael)
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Can I ask a brief supplementary question?

Brendan Howlin (Wexford, Labour)
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If you do so, we will lose the final question, which is your question. I call Question No. 67.