Ann Ormonde (Fianna Fail)

I come from a medical background and can tell the Senator that. I started there and will finish there.

On the issue of value for money, we all agree significant funding has been put into the health service, but we did not get great value for it. We do not know where the money went. It seems to have gone towards administrative costs and got lost in administration. It is important that the patient and value for money are the focus of our thinking. The patient must come first and we must ensure we have a system that gives a good return for taxpayers' money.

Let us start there. Nobody will say that we will have reform overnight, but the Minister, with her team, will do everything in her power to ensure reform. The Minister is bright, as bright as any Member of this House or the other and I challenge anyone to deny that. The Minister will take on all objectors because she understands and has a good grasp of the issues.

I welcome Part 8 and the proposal to set up fora, but I am not sure how this will work. How many fora will there be in each local authority area and what people will be on them? When will they be up and running? When will the regulations be introduced? It is important they begin immediately. I am unsure about what the advisory panels will do. We are setting up a hierarchy with the health executive under which we will have the regional fora which will work with local representation. However, I worry that if we set about diluting or splintering the hierarchical structure we are setting up, we will return to more of the same. We need to keep the hierarchical structure tight rather than introduce the lateral approach we had in the previous system which did not work. I am anxious that the Minister bear this in mind.

Another issue is the consultants who must be brought on board. Some 90% of them are ready to come on board to discuss how best we can improve the service, bring health professionals and administrative staff on board and get them working together. The system will not work unless it is integrated, co-operative and co-ordinated to maximise returns and ensure the patient comes first.

Many speakers have mentioned the number of reports we have had on health reform. We had to start somewhere. I came here from the education system where there were reports up to my eyes over the years. However, at some stage the reports worked and some parts worked very well. Under what was covered in the Hanly report Nenagh hospital is getting a huge extension which will increase accident and emergency services. The same is true for Ennis hospital.