Kathleen O'Meara (Labour)

We have probably exhausted the debate on this matter and we know where we stand in respect of it. The Minister of State indicated that issuing a mission statement will be the responsibility of the board. He will be aware, however, that if something is not set down in legislation, there is no guarantee it will happen. He stated that people's rights have been codified in existing health legislation. However, this has not prevented situations arising where individuals have not been able to access the services they require. As a result, groups such as the Disability Federation of Ireland have been obliged to develop a major lobby in order to ensure that the concerns of those they represent are heard.

A great deal of lip service is paid to the work done by the community and voluntary sector. In that context, the Minister of State referred to the Government's position as outlined in the health strategy, etc. In a submission I received, which I am sure the Minister of State has seen, entitled Critique of, and Proposed Amendments to the Health Bill (2004), a joint position paper by The Wheel, the organisation of the voluntary and community sector, and the Disability Federation of Ireland, it is noted that the Government recognised in the White Paper Supporting Voluntary Activity published in 2000 that the community and voluntary sector is an essential and enhancing partner in economic and social development. This legislation, however, does not recognise that partnership. It will be difficult, therefore, for the sector to become involved. The executive would have to be proactive in the area and if it is not in the legislation, why would it bother? The Minister said the executive will be management-driven rather than representational.

We have not reached the point where an individual has an entitlement to the service he or she needs, although we have come far and €11 billion is being spent on the health service. A major problem, however, is the continuing struggle people face to get what they need, particularly families who have a member with a disability. They face an ongoing struggle to secure the services and the assistance they need for a child with a disability, be it physical or intellectual. It cannot be said, therefore, that individual entitlement, as it is set down now, is the same as getting it and I am seriously concerned about this. This should be a cornerstone of the legislation but is missing.