Dáil debates

Tuesday, 7 October 2008

Ceisteanna — Questions

Departmental Agencies.

2:30 pm

Photo of Leo VaradkarLeo Varadkar (Dublin West, Fine Gael)
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Question 1: To ask the Taoiseach if he will complete an efficiency review and audit of all State agencies and bodies under the responsibility of his Department; if he plans to merge or abolish any State agencies or bodies; and if he will make a statement on the matter. [20598/08]

Photo of Eamon GilmoreEamon Gilmore (Dún Laoghaire, Labour)
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Question 2: To ask the Taoiseach his plans to change the structure or organisation of State boards or agencies operating under the aegis of his Department; and if he will make a statement on the matter. [29626/08]

Photo of Brian CowenBrian Cowen (Laois-Offaly, Fianna Fail)
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I propose to take Questions Nos. 1 and 2 together.

In accordance with the initiative I announced in my 2008 budget speech, an efficiency review of my Department's expenditure and related activities was undertaken earlier this year. The review identified a number of proposals which, when fully implemented, will result in greater administrative efficiency in my Department and the bodies for which my Department has responsibility. The review considered those bodies which are in receipt of funding from my Department's Vote, which include the National Economic and Social Development Office, NESDO, comprising the National Economic and Social Council, NESC, the National Economic and Social Forum, NESF, and the National Centre for Partnership and Performance, NCPP.

Other bodies in receipt of funding from the Department's Vote include the Moriarty tribunal, the National Forum on Europe, the Newfoundland and Labrador Business Partnerships and the Active Citizenship Office.

The establishment of NESDO was in itself an effort to capture the efficiency gains of sharing basic support services across three formerly separate entities, namely NESC, NESF and NCPP, while at the same time encouraging the output benefit of increased co-ordination between them in areas of common interest.

As part of the implementation of the programme of reviews under the value for money and policy review initiative, a comprehensive review of NESDO is nearing completion. The draft review report is being considered by the steering committee for the review and will be considered by an external reviewer, before being finalised. The outcome of this review will provide a solid base for the identification of such further efficiencies as may be achieved by NESDO.

In general, the level of administrative funding provided to the other bodies in receipt of moneys from my Department is small. Nevertheless, it is my view that every scope for administrative efficiencies must be pursued and this is being done in the context of the overall review of administrative expenditure. In general, it is the Department's practice to make use of shared administrative facilities and services to reduce administrative overheads.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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In general, that may be so. As the Taoiseach is aware, the NESC, NESF and NESDO now all share administrative facilities. Why has this model not been applied across other agencies? Deputy Varadkar produced a detailed document about the growth in the number of agencies, sub-agencies and quangos in recent years. The philosophy mentioned by the Taoiseach does not apply in general because they all have their own administrative locations and so on. I am glad the Minister of State at the Department of Finance has taken an interest in this issue and he has said he will prioritise a number of these next year. Is the Taoiseach aware of the priorities he is setting out in this regard? Will there be an end to the duplication and triplication of duties and resources in this area? Will the Minister of State bring forward his proposals as a priority shortly?

Photo of Brian CowenBrian Cowen (Laois-Offaly, Fianna Fail)
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The Minister of State has been asked to examine this issue by the Minister for Finance within the Department of Finance and the public service. What is informing the exercise generally in terms of the principles to apply relates to the OECD report on the public service and the task force currently drawing up an action plan to implement and sequence the report's recommendations in a way that will bring about greater efficiencies and to address the question raised in the report regarding agencies under the aegis of various Departments. That work is advanced and will be available shortly.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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The Taoiseach will be aware that under the Good Friday Agreement, six new North-South bodies were set up. I am well aware of the sensitivities that applied ten years ago when the Agreement was adopted, signed and voted on by the peoples, North and South, but surely we should be in a position, having moved on to a time of peace and progress, to consider these bodies for all-island status. Has consideration been given to that by the Government in conjunction with the Northern Ireland Assembly? Why do we have to have six North-South bodies, given the economic challenge that exists, North and South? Is this not an area in which the Taoiseach could give leadership and state that, instead of having six separate bodies, we should have all-island entities, reduce the number and increase their effectiveness?

Photo of Brian CowenBrian Cowen (Laois-Offaly, Fianna Fail)
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That requires political agreement. It is important that there is a structured institutional architecture between the North and South in advancing the objectives of the Good Friday Agreement. In the past, it was suggested co-operation could be considered on a case by case basis, which could well depend on the relative enthusiasm or commitment of the incumbents in office and the relevant Department or agency. The purpose of insisting on six areas of co-operation and having a structured arrangement was to ensure consistency and continuity. It was originally envisaged that would evolve into wider areas of co-operation where further structured co-operation could be advanced and agreed. For example, we do not have a structured co-operative system in the area of energy. We have witnessed many advancements in this area because of the impetus from Europe regarding competition issues, the Commission for Energy Regulation, which we established, and the setting up of the all-island electricity market. There has been a great deal of co-operation in this area and this enhances the argument for a structured set up on that basis since substantive co-operation is taking place.

We should not underestimate the political significance of allowing our respective peoples to see that a system is in place which is working and being maintained and which is not simply subject to an unstructured scenario where one may not get the system in place that one wants to see. I do not agree with the Deputy that we should coalesce those six areas. I acknowledge his comments about all-island structures, which could be argued for on a case by case basis. At present, there are some difficulties. We must proceed as we are and try to encourage the spirit of the agreement, which was to consider other areas of co-operation and provide a structured basis for them.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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There should be no division, North or South, in terms of politics or so on, regarding tourism. The best known landmark in the country is the Giant's Causeway. As someone who served in the tourism Department, it is my opinion that visitors to the island are visitors to all of Ireland. In a tightened economic situation, it would be much more effective to have a real marketing proposal for the island of Ireland. Whether visitors arrive in Belfast, Cork, Dublin or Donegal, they are visitors to the island of Ireland for everything that we have to offer. Could we not deal with the former sensitivities in this matter and have a real, powerful and effective all-Ireland tourism marketing board, which would not infringe on politics in any way?

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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That body does not fall within the Department of the Taoiseach, but he may answer.

Photo of Brian CowenBrian Cowen (Laois-Offaly, Fianna Fail)
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Tourism Ireland is an all-island body that provides for the international marketing of the island as a whole. Our different tourism support agencies within the island could be examined, but one requires political confidence building to achieve advances in that area. Tourism Ireland is an excellent example of the common sense nature of the all-island approach.

Photo of Eamon GilmoreEamon Gilmore (Dún Laoghaire, Labour)
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In his first reply, the Taoiseach stated something to the effect that a comprehensive review of the National Economic and Social Development Office, NESDO, is under way, which would lay a solid basis for achieving further efficiencies as might be possible. It sounds as if NESDO will either be wound up or given responsibility for the functions of other agencies. Which direction will be taken?

For some time, it has been speculated that the Government is contemplating an amalgamation of the Combat Poverty Agency, the Equality Authority and the Irish Human Rights Commission. What is the Government's position on these agencies?

Photo of Brian CowenBrian Cowen (Laois-Offaly, Fianna Fail)
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The Deputy will understand that I cannot anticipate any Government decisions that have not yet been taken in any of these matters. The aims of the NESDO value for money review is to analyse the output of the grant-in-aid funding provided to NESDO, to determine the impact of the development of public policy in line with the objectives of the Department of the Taoiseach and other relevant public organisations for NESDO and to inform future funding, administration, structural and policy decisions regarding NESDO. The review is being finalised by the steering group and will be subjected to external examination and come to me as Taoiseach thereafter. I cannot anticipate its outcome. This is not to be coy with the Deputy, but to be frank. There are no decisions as yet.

As the Deputy knows, NESDO was a way of capturing efficiency gains in respect of the three constituent bodies under its aegis and was a good example of what could be achieved in trying to deal with administrative savings. The value for money review is part of what one would expect in terms of ensuring taxpayers are getting the maximum benefit from grants-in-aid to all organisations.

Photo of Eamon GilmoreEamon Gilmore (Dún Laoghaire, Labour)
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Will the Taoiseach respond to the second part of my question concerning the future of the Combat Poverty Agency, the Equality Authority and the Irish Human Rights Commission?

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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There is a slight difficulty in that they do not fall within the remit of the Department of the Taoiseach, as the Deputy well knows.

Photo of Eamon GilmoreEamon Gilmore (Dún Laoghaire, Labour)
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The Taoiseach might know something about it.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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He might have heard something on the grapevine.

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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I am entirely in his hands then.

Photo of Eamon GilmoreEamon Gilmore (Dún Laoghaire, Labour)
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He might like to share that information. There is much speculation about these bodies. I simply asked him the Government's view on it.

Photo of Brian CowenBrian Cowen (Laois-Offaly, Fianna Fail)
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As the Deputy knows from his own internal organisational review, about which I have been reading, everyone will be informed at the appropriate time.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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He heard it on the grapevine.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Does the Taoiseach agree that the recent comment that the board of FÁS holding a two-day meeting at Mount Juliet recently was inappropriate in the current circumstances, was not the whole story? It should be just inappropriate full-stop, not just because of recessionary times. Indeed, in a time of plenty that type of culture should not be given any approval by Government for State agencies and State boards. Questions Nos. 3 to 6 deal with State boards and, as we are addressing the same entities in the responses to Questions Nos. 1 and 2, what intent does the Taoiseach have to address the culture that has presented itself in the State sector, which tries to emulate what has been unfortunate practice in the private sector for so long? Surely it is an absolute requirement that the Government make an intervention and that sane and sensible practices are adopted by those entrusted to manage our State boards and agencies, without exception.

Concerning appointments, did the former Taoiseach make any appointments to State boards in the period between the announcement of his resignation and the resignation? If so, did he consult with the current Taoiseach in respect of these appointments?

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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That is not relevant to these questions, as the Deputy well knows.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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It is, of course. I beg the Ceann Comhairle's pardon. Question No. 6 refers to "the names of the persons appointed since May 2008 to State boards and agencies for which his Department is responsible". Of course it is relevant, that is the period when the former Taoiseach held office.

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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We are dealing with Questions Nos. 1 and 2.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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The monitor refers to Questions Nos. 3 to 6. I indicated I was referring to Questions Nos. 1 and 2 and 3 to 6.

Photo of Brian CowenBrian Cowen (Laois-Offaly, Fianna Fail)
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Deputy Ó Caoláin should always check with the referee before looking at the scoreboard.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Maybe the Ceann Comhairle should liaise with his camera crews.

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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The Deputy should assume the Chair is correct.

Photo of Caoimhghín Ó CaoláinCaoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Dare I ever doubt it? We can defer the question on these specific appointments if the Ceann Comhairle wishes. The monitors can be corrected. I will rest my question on the first issue raised, namely, a movement towards best practice and acceptable practice by all those entrusted to manage and oversee our State agencies and boards. What steps is the Taoiseach taking in this area?

Photo of Brian CowenBrian Cowen (Laois-Offaly, Fianna Fail)
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The purpose of the OECD study of the public service is to examine how integrated and relevant is the service and the extent to which we can get people to work across organisational boundaries to improve the service to citizens and to examine the question of how we make it more citizen friendly. The idea behind setting up some of these agencies was to grant a specific remit in terms of the delivery of specific services to the public. It is timely that we have a review of the issue. The flexibility required, which spawned some of the establishment of agencies, was in order to overcome the constraints of departmental delivery systems, so that people could get out into the community and deliver services ascribed to the various organisations being set up.

The next phase of public service reform must examine how existing agencies are governed, the dialogue and accountability arrangements in place between parent Departments and their agencies, whether there is scope for agencies to merge with others and whether there is an ongoing need for the service they provide. The real issue in respect of agencies is guaranteeing better outcomes for the public. The task force on the public service will examine that issue and how best to implement the recommendations of the OECD so that we do this in a proper way. The OECD report indicates that progressing the reform and modernisation agenda for public service lies not solely in changing the institutional architecture or the allocation of responsibilities between Departments, agencies and offices or between different levels of Government but in getting the different parts of the system working differently, with greater focus on collaboration in achieving wider societal goals and in assuring that reforms introduced are appropriately sequenced. That is the challenge I set for the task force and it will report on the matter shortly.

With regard to the specific matters, I do not want to discuss individual organisations or circumstances. Of course there is a need for us to reflect on the fact that taxpayers' money must be seen to be spent to the best possible value. Sometimes certain issues are raised as if they were symptomatic of a wider problem within the public service. Where there are difficulties and problems these must be addressed and we must see that the public service ethos is prevalent and prominent in respect of how we conduct our business in these agencies.

Photo of Charles FlanaganCharles Flanagan (Laois-Offaly, Fine Gael)
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Arising from the reference the Taoiseach made earlier to the Human Rights Commission and the Good Friday Agreement, will he confirm that the position of the Human Rights Commission is in line with the Good Friday Agreement and our obligations under that Agreement to establish an independent human rights commission? In the context of the proposed review to which the Taoiseach referred, I put to him the importance of ensuring that our obligation, as voted upon by the people, is maintained in its original form. A merging, as proposed, of the Human Rights Commission with other bodies could in effect lead to what the eminent and respected parliamentarian from across the water, Dr. Kevin McNamara of the Labour Party, referred to as an undermining of the Good Friday Agreement, were such a proposal to be undertaken. Having regard to the status of the Human Rights Commission, will the Taoiseach give consideration to that commission being answerable, not to the Department of Justice, Equality and Law Reform but to the Houses of the Oireachtas?

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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The problem is that the Human Rights Commission comes under the ambit of the Department of Justice, Equality and Law Reform and the Deputy knows that.

Photo of Charles FlanaganCharles Flanagan (Laois-Offaly, Fine Gael)
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It comes under the direct mandate of the Good Friday Agreement. I am conscious of the work undertaken by the Taoiseach towards the reaching of that Agreement and the importance of the mandate under that Agreement. Any tampering or interference with the status of that Agreement could give rise to difficulties of a type not envisaged.

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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The Taoiseach cannot be expected to answer for the Human Rights Commission when it comes under the Department of Justice, Equality and Law Reform. That is the problem we have.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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I am glad to hear the Taoiseach talking about value for money and we all support him in that. During the events of last week, however, this House discussed the financial crisis facing the country. The process agreed to by virtually all sides of the House was accompanied by serious concern expressed about the remuneration packages and bonuses of certain CEOs of the banks. It was, therefore, with astonishment and disbelief that we heard a story break, within 12 hours, of a €1.4 million bonus given to the top ranks of the Health Service Executive who preside over our health services——

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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The HSE comes under the Department of Health and Children.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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That is true but it is a State agency——

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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Deputy Reilly cannot——

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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With due respect, this matter has infuriated the ordinary people in this country. Last night the Mater Hospital closed for an hour because it could not cope. There are people lying on trolleys up and down the length of the country.

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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We cannot discuss that at the present time.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Will the Taoiseach answer——

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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These questions must relate to the Taoiseach's Department.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Will the Taoiseach intervene and ensure that public money is spent on patient services, not on bonuses?

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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Deputy Reilly has gone away altogether from the issue and is off wandering around the countryside.

Photo of Emmet StaggEmmet Stagg (Kildare North, Labour)
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Regarding the review the Taoiseach said is to be undertaken, will that deal only with the abolition of some quangos and the merger of others? Does he agree that it should also take into account the democratic deficit created by the quangos themselves, by the fact that we transferred power out of this House to such agencies? The Ministers under whose remit these operate no longer have power or authority to answer in this House, except in the most general sense, for the activities of the agencies that are spending taxpayers' money. Does the Taoiseach agree that to bring back that power here, returning it to the Ministers of the Executive in order that this House can question them about the activities of the quangos, is almost more important that merging those quangos or abolishing them?

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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The Taoiseach only can answer for the State agencies and bodies under the aegis of his own Department.

Photo of Emmet StaggEmmet Stagg (Kildare North, Labour)
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He should reply in respect of his own Department.

3:00 pm

Photo of Brian CowenBrian Cowen (Laois-Offaly, Fianna Fail)
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To be helpful, on the question of the OECD's comments on how to deliver a modern public service, it requires flexibility and is about changes of attitude and approach. The genuine requirement of public accountability also arises. How does one provide discretion at the appropriate level, while at the same time ensuring criteria are in place to avoid what might be regarded as arbitrary decision making under the guise of the use of discretion? These are not easy issues in terms of best practice in public administration. However, in the context of trying to provide services on the ground, there must be a tie-up or collaboration between the health, local education and welfare services. I refer, for example, to efforts to deal with how one should help disadvantaged pupils in schools, how one ensures that people attend school or how one helps them to do so while well fed and nourished. Apart from putting a remedial teacher in a classroom, there is a range of attributes that will secure the same outcome.

What is under discussion is the scenario whereby everyone sticks to the silo system, in which this is one's own job, that is the other person's job and so on. Consequently, although everyone seeks, with the best of good faith, to provide such services, they are not co-ordinated sufficiently well to achieve the outcomes one would expect, given the resources being input from various public sector sources. To get down to the nitty gritty, what institutional structure is required to make that happen better than was the case previously?

The Fitzgerald report is an excellent report in respect of its succinctness. It comes from a person who has operated at the highest echelons of public administration and with a fair amount of respect from all sides. For example, he has made the point that although a great deal of money was going into certain areas of Limerick, which was the subject of the report, the cumulative output was not what one would expect, given the resources that were being invested. This is because a lack of co-ordination will exist unless some overarching principle is in play. This involves a cultural change in how services are delivered, as well as the institutional and organisational arrangements. By providing those local agencies in Limerick that were established to pull all that together, we are witnessing a far better outcome for the same level of resources. In many cases, resources are not at issue.

This is what the OECD means when it refers to trying to get an integrated public service. Quite understandably, precedent has built up in various Departments of State over the years. Arising from this, various types of agencies or public service vehicles have been established to deliver the expanded services that are voted in this House on an annual or continual basis. However, the problem as I perceive it is that there must be overarching senior management within the public service with an overview of all of that. We must get in place a structure that delivers the bang for the buck taxpayers are entitled to expect.

All the time, this argument falls back to Members in respect of the parameters of their debates, for example, less money means fewer services. However, if the money and services are better integrated, it may not be a resource issue at all. In some areas of the public service such as, for example, the aforementioned health service, the level of increase in resources, despite agreement by all that it should be provided as a priority, in many instances is bringing improvements to services that Members do not communicate to the public. Many areas of the health services are working well and have improved under the new structure. There are other areas which perennially are a problem. Such problems are structural because of a lack of a tie-up between primary care, acute hospital care and the accident and emergency services. Members know this to be the case and rather than falling back on the continual arguments in this Chamber, which throw more heat than light on the issue, we must get back out to those communities and tell them that while sufficient resources are being provided, they are not being provided in a sufficiently co-ordinated manner because of the perennial problems that are highlighted continually. In many cases, best practice models can be seen in various parts of the service, such as the community or acute hospital services. People spoke to respective parties about these issues, where we are not seeing that being translated across the service in a way expected if, for example, it was an industry or best practice issue where greater productivity or better organisational arrangements are evident in the provision of services in one part of the country as against another.

That is the challenge and all of us committed to public service provision must ensure that as we defend our political position, we also recognise that the public confidence must be bolstered in regard to the delivery of these services. People are saying they are not getting a service in an expected way in return for the amount of taxpayers' money they are providing — it is the taxpayer who provides the money.

We must get back to a consumer and citizen focus and to recognising that service providers, as important representatives and constituents in policy formulation, are not the full picture. The full picture involves those people awaiting and requiring services and in many cases they are being provided to a far better standard than we give credit for in that we try to portray every aspect of the service as being in crisis management but that is not the case. At the same time, where we identify best practice we do not translate it across the service sufficiently quickly. On behalf of citizens, we must address that issue, not just as Government but as Parliament.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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On that topic——

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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I will allow Deputy Stagg to finish first.

Photo of Emmet StaggEmmet Stagg (Kildare North, Labour)
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I will be brief. The Taoiseach's statement is very interesting and I agree with every word but he did not address my question. My question is whether the Taoiseach will consider changing the rules so that Ministers who have these agencies under their remit will answer to the representatives of the public who are waiting for and needing services and who are getting them in many cases.

Photo of Brian CowenBrian Cowen (Laois-Offaly, Fianna Fail)
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I meant to answer that aspect. If there is a health service consisting of 140,000 employees, for example, the idea that operational responsibility for every action of the health service should be handled in the House by a Minister is not a sensible management model to adopt. We must be responsible for policy and where there are systems failures, the democratic mandate of every Member is to come to the House, highlight those issues and have them addressed.

Real accountability is not about trying to point out that we do not have a perfect system every day of the week, real accountability is about identifying mistakes and putting systems in place so it is less likely they will be repeated in future. The definition of accountability should take this into account, but too often it becomes an apportioning of blame game and, more important, the apportioning of the political blame game. This is when everybody knows that regardless of who the incumbent in an office is, they are not responsible for every operational failure in the health service any more than they are responsible for every operational success.

The overall policy structure and the principle of accountability should be as I have outlined. Then we can have a better debate, which would be far more collaborative and would bring about the prospect of improvements in the services on the ground, unlike the case currently when too often certain political opportunism takes over, whatever the issue involved.

Photo of Emmet StaggEmmet Stagg (Kildare North, Labour)
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The answer is "No" then.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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I welcome the Taoiseach's comments regarding an incumbent not being responsible for every minutiae of the health service. That is why we asked for a patient safety authority. All these Deputies to whom people come with stories of misdiagnosis or other issues can pass them on to an identifiable body to deal with them in a positive fashion and in confidence, without the glare of publicity or the need to resort to litigation. This saves everybody much time and money and gives people the justice and clarity needed when a loved one or the people themselves have a problem with the health service.

I disagree with Deputy Stagg on one point. The problem in our health service and the reason the Mater had to close yesterday——

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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We are not having a debate on the health service now.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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With due respect to the Ceann Comhairle, the Taoiseach stated a few moments ago that this issue is not all about resources and I agree, but resources are relevant. We do not have enough long-stay beds in this country and the fair deal has not come in. There were 130 people lying in beds in the Mater a couple of weeks ago waiting for discharge but with nowhere to go. That is why it has to close down.

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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We cannot discuss that.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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On the other side, a primary care strategy promised eight years ago to bring diagnostics to the community but it has not happened. What have we got? We have accident and emergency and hospital systems bunged up, where people cannot get out when they have had treatment because there is nowhere to go and people are coming in when they should not have to because they cannot get a diagnosis and treatment in the community.

Photo of John O'DonoghueJohn O'Donoghue (Kerry South, Ceann Comhairle)
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I do not know if the Taoiseach wishes to comment but it is completely outside the ambit of the question.

Photo of Brian CowenBrian Cowen (Laois-Offaly, Fianna Fail)
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I was making the point that there is another aspect to the delay in implementing policy, namely, that service providers in certain areas have a view. For example, some time was required before the provision of a primary care centre in the north inner city of Dublin was secured because the matter had to be negotiated. It is not simply a question of the Government, the HSE or personnel not being prepared to move forward with a new model. Clearly, if people keep complaining that the model does not work sufficiently well, one has to advocate for the new model. As I understand it, everybody agrees that this model is a preparedness to develop community services, which involves ensuring that the acute hospital sector does not capture the level of resources it currently captures.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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That cannot be done without funds.

Photo of Brian CowenBrian Cowen (Laois-Offaly, Fianna Fail)
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There is no doubt that a strong lobby and vested interest wishes to retain the current level of resources within the acute hospital sector. Various members of the Deputy's profession, depending on whether they are on the primary care or acute care side of the line, have a certain view on the matter. Let us be fair and honest about it.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Yes, let us be fair and honest and admit the resources are not available.

Photo of Brian CowenBrian Cowen (Laois-Offaly, Fianna Fail)
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There is a responsibility on everyone not to prevaricate on concluding contracts over numbers of years rather than numbers of months.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Talk about scoring political points, the Taoiseach is trying to blame vested interests.

Photo of Brian CowenBrian Cowen (Laois-Offaly, Fianna Fail)
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The problem with the Deputy is that he shouts people down when he gets a response.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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I do not allow people to twist the facts.

Photo of Brian CowenBrian Cowen (Laois-Offaly, Fianna Fail)
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Having listened to the Deputy, I am simply stating, as a former Minister for Health and Children with some knowledge of the reforms that are taking place, that it is time we were prepared to acknowledge that there are service providers' interests which also have to be taken into account if we are to make the progress we need to make. It is not simply a question of the Government or the Opposition not providing sufficient resources.

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)
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Service providers have not obstructed movement for seven years. The issue is one of a lack of money.