Kathleen O'Meara (Labour)

It is the other way around. I presume that the Hanly report will balance that out to some extent.

The issue of democratic accountability is important in the context of the reform and the total abolition of the health boards. One only need only consider issues such as the blood scandal. Democratic accountability is extremely important, as is the way in which the system of accountability is structured. I look forward to the legislation in that regard and I urge the Minister to take that point on board. Whatever way it is devised, accountability must be built in to the structure of the reforms being proposed.

The Minister referred to an extended role for the Joint Committee on Health and Children. This is excellent, in theory, but it can only work if the committee is given the resources and the powers it will need to ensure accountability. Unless the committee operates on the same level as the Committee of Public Accounts, its function of democratic accountability cannot be fulfilled.

My final point relates to the role of consultants. I wish the Minister and the Department well in their battle with the consultants. I have no doubt that it will be a monumental battle. There will be blood on the floor before this is over. The Department is taking on one of the strongest vested interests in the country. The consultants are coming to the Department with a contract that the Department negotiated which, in effect, gives them everything. They are now being asked to give something back and, in any negotiations when one is taking something away from a group, they will strongly resist it.

It is important to note, however, that the wider context within which consultants previously operated is no longer the same. The consultant was always seen as the authority figure in a hospital and it is welcome that this will be brought to an end in the reform programme. In the same way as nurses, other doctors and workers in the health service, consultants are the servants of the people. I accept that we must pay people for their skills and level of education. We need their skills and expertise and we need to maintain what we currently get, namely, a high level of commitment from many consultants. We must, however, alter the current contract to make it fair and, to use the phrase employed by Senator Minihan, to get better value for money.