Frank Feighan (Fine Gael)

She is certainly an exceptional lady. Among the Minister's recommendation is the abolition of the health boards. Opinion is divided on whether these boards are a waste of money but some people say privately that they are very political. I imagine there will be strenuous opposition to their demise. A little over two months ago in this House, I said that while the health boards were a problem they were not the overall problem. The Minister, however, has the political will to take on the health boards and the consultants. It will be a dangerous road for the Minister to take because he may not get full backing from his own party. Like the dual mandate, however, it looks as if the health boards will go and the Minister has set out his stall in this regard. The abolition of the health boards does not represent a panacea for the health services and, unfortunately, it could be seen as a reduction of the input of local democracy. The health boards had some plus points.

Single issue Dáil candidates found fertile ground in the area of hospital action and they are the bane of the main Government party, Fianna Fáil. Such candidates were elected in Cavan-Monaghan, Wexford, Galway East and other constituencies. Those Independent Deputies are very effective and have brought a certain flavour to debates in the Lower House.

People accept, however, that local hospitals are not appropriate for many major medical procedures; they do not have multidisciplinary teams to perform the necessary number of procedures to ensure competence. I know of some people who had to go for operations in areas which lacked the competence of larger hospitals.

What acceptable compromise role can be arranged for Roscommon hospital, for example, in my own constituency? One of the key questions raised by the centralisation of hospital services is how long it will take patients, particularly those in rural areas, to get to hospital in an emergency. In such circumstances, ambulance services will have to be more efficient in order to gain public confidence. Every week, constituents tell me that they called for an ambulance which took an hour or 90 minutes to arrive. The Minister will continue to face such problems unless rural ambulance services can be improved.

A restructured ambulance service is needed so that the Minister's reforms can be implemented. The existing service needs more resources, including funding, and more ambulance centres are required also.