Kathleen O'Meara (Labour)

I know we have spent a lot of time on these amendments. I thank the Minister for his Second Stage approach. His setting out of where the Government is coming from on this issue has been very useful. It is not news to hear him setting that out. However, he has been clear and open and I commend him on that approach.

We would take a different approach. We live in a democracy and we are entitled to take different approaches. As an aside, like other Senators on this side of the House, I have had representations from Senator Glynn's party colleagues regarding the abolition of the health boards with which they were not happy. I am sure he is aware of that.

I have no difficulty with reform. I accept that times have changed and we must be cognisant of whether the structures we have in place are the most effective for the delivery of the best possible service for people who need it. That must be our ultimate aim. Everybody would agree with that. The question is how we go about it.

The structure the Minister is setting out in this legislation is over-centralised and cuts out any sense of local involvement, consultation, accountability — call it what one will. The Minister may say that the health board structure did not work. As many people have said, health boards delivered excellent services, often on their own initiative and in response to need as they saw it. However, there was inconsistency between health boards on a whole range of issues, including, as Senator O'Toole mentioned, child abuse.

Is it necessary in reforming that structure and creating an integrated service — and as the Minister says, he who pays the piper calls the tune — to completely abolish democratic accountability and create such a centralised structure that people on the ground have nowhere to go, because I do not accept that the regional forums are anything other than talking shops? I am not saying that local councillors will not air what people have to say, but that is all that will happen. They will air what people have to say. It will very likely be reported in the local paper and that is as far as it will go because, ultimately, the board will make decisions at the Minister's direction.

The amendment under discussion is at the core of our fundamental problem with this legislation. The Minister spoke in general and vague terms about the possibility of the Government coming forward with legislation which will have the issue of entitlement at its heart. It sounds vague. It may or may not happen. We know this Government has something of an allergic reaction to anything with a rights-based approach, so I would not hold out much hope on that front.

We have had a very useful discussion on this amendment on the principles and vision of this board and also on the issue of entitlement. I do not intend to take it any further.