Brian Lenihan Jnr (Dublin West, Fianna Fail)

Something could be achieved at that moment. After that it is downhill from my brief perusal of the notes I have before me. I would be pleased to address the points raised by the Senators, for example the question of consultation. The legislation is not being rushed through the Houses without consultation because the Government announced the reform programme 18 months ago and the need and character of this legislation has been well signalled in the intervening period.

This amendment is dressed up in the very fashionable language of a rights-based approach but it addresses the issues of eligibility for health services which this Bill does not purport to address. The only way to give flesh and blood to a rights-based approach in the context of the administration of a service as vast as our health and social services is to define the rights in terms of eligibility. To have a rights-based approach it is necessary to translate and specify what the rights mean in the context of a hospital service, general medical and practitioner services and right of access to drugs and social services. The health legislation already provides for all of that. Not alone are there many sections but there are many regulations spelling out in great detail the eligibility of a patient or individual to a particular service. That is a rights-based approach which has been embedded in our legislation since the 1947 Act.

That approach to eligibility has been a cornerstone of our health legislation but this Bill is not about that. It is about organisation and management reform within the health system. Senators Henry and Browne noted that the word patient is not often mentioned in this legislation but if one took a referendum of patients in Ireland on whether they agreed with the proposition that we should have nine or ten health boards or a unified national administration one would get a very clear answer from patients about what they wanted.