Kathleen O'Meara (Labour)

I note that the Minister of State's boss, the Tánaiste Minister for Health and Children, Deputy Harney, made exactly the same point in the Dáil last week about eligibility. I disagree fundamentally with the Minister of State that our amendment is about eligibility. It is not. It is about entitlement. The earlier health legislation which is rendered obsolete by this new Bill contains entitlement provisions. Section 7(1) of the Bill states: "The object of the Executive is to use the resources available to it in the most beneficial, effective and efficient manner to improve, promote and protect the health and welfare of the public." There is no mention of the individual there.

We could engage in an argument which says that the public consists of individuals but this legislation removes what exists, namely an entitlement. It is removing a right that individuals have. The Minister of State is correct to say that people have used it in legal battles. There have been legal battles and the courts have decided how people should be treated. I do not agree with that, although the courts play a major role in medical matters which no doubt causes grave anxiety among doctors in particular, and hospitals and other practitioners.

I do not know if the Minister of State is correct when he says that were we to conduct a referendum the majority of people would vote to abolish the health boards. The Minister of State says "it is the conviction of the Government" and that is certainly the case. This legislation makes clear that it is the Government's conviction that the health boards are inefficient, do not work or deliver what the Government wants them to deliver. That is fine but in bringing forward this legislation and abolishing the health boards a very important layer has also been abolished, namely, accountability to the person in the street, not just the patient but the person who elects councillors who sat on health boards.

This legislation cuts out the community voice of protest about Government decisions on the health service in an area. That is one of its objectives. If there was serious local anxiety about a decision regarding a health service, for example a hospital, the community has had access to the administrative structure which partly drives that decision. The health boards no longer exist, so the community no longer has access. Publicly-elected councillors no longer sit on a body which discusses these issues, so there is no access. The regional forums mentioned in the legislation do not amount to anything more than a talking shop. They cannot do anything. The health service executive, under the clear direction of Minister, will be the board which makes day-to-day decisions about hospitals and services in this country.

It is fashionable to write off the concerns of local people. The current Administration will say these are usually politically motivated campaigns involving people like myself. The Minister of State is nodding. He would agree, considering where he is sitting.