Ulick Burke (Fine Gael)

The most important matter is that we recognise that the very many personnel within the health boards were top class in delivering the services. The Minister of State referred in his contribution to the strengthening of governance and accountability across the system. Surely this raises a question regarding the governance of the health services at local level and accountability. The Minister stated we must make changes in this area, but one must ask what is wrong with the current system.

Many speakers have said money is being invested but that they do not know where it is going. It is the responsibility of the Government to know where it is going and what it is being spent on. Therefore, the Minister has failed to recognise that he has a responsibility in regard to the failure of the system. The only thing he has done in response to some people or some sections of the media is to remove public representatives from the health boards and claim this will ultimately lead to a proper health service.

What has happened in recent years under the Minister's governance? Despite the fact that we were promised the elimination of waiting lists for health services in every area, whether it be in the public or private sector, they have become longer. One might argue that we have a system in place whereby we can send patients abroad where we can buy treatment for them. However, many people at the coalface contend this is wrong because we would have the necessary facilities if only they were organised. The Government has failed to organise them at a low level. If one went into an accident and emergency unit in any hospital, one would note the level of organisation. There is nobody in control to manage the needs of people in this area and consequently the nursing staff have to take all the abuse.

Are we now contending that we will have the desired response if we establish a senior executive that will operate at a distance? Consider all the reports, one of which was mentioned by Senator White and which is supposed to be the absolute gospel dictating how things are to be done. The strategy entitled Quality and Fairness — A Health System for You, published a few years ago, was launched in a blaze of glory. It was to contain all the answers and it was touted that every ill in the health system was to be eliminated within a short time. Within 12 months, however, there was a total withdrawal from that policy document in favour of the Hanly report, which proposes the very opposite to what the former document proposed for the delivery of health services.

There is no doubt that under the Minister for Health and Children, we are leaderless and rudderless, and there is a total absence of any coherent policy to deliver the service needed on the ground. I do not believe any measures in this Bill will change that.