David Norris (Independent)

I agree with Senator O'Brien in complimenting the House and its political staff on getting this debate scheduled so quickly. It does a public service that this matter be so ventilated. It is very useful and I am glad we are having the debate. I wonder whether the Tánaiste, Deputy Harney, now regrets so courageously taking on the poisoned chalice of the Health and Children Ministry. It certainly was a courageous decision and confronting this task provides many headaches. She is right in saying that the whole system of health delivery needs to be reviewed.

The specific tragic case of Mr. Walsh is an appalling event. One would first of all have to send one's sympathy to his relatives. First they had the incidence of his illness and then they had to stand impotently by while he was locked into a kind of lunatic bureaucracy. I understand Mr. Walsh was already known to suffer from a peptic ulcer, which creates certain indications. I would have thought he should have been put into intensive care immediately. This kind of bleeding is amenable to fairly simple treatment through endoscopy whereby a tube is inserted and the bleeding is cauterised, which is successful in 80% of cases. Without this procedure it is almost always fatal. It is not a major, sophisticated, complicated or difficult operation to undertake. It astonishes me that people stood idly by while this man apparently bled to death.

We need to get all the facts — I understand a report is due and we must await judgment. It would be quite wrong to judge specific individuals or name anybody at this point. While I do not always agree with Senator Mansergh, he was very wise in what he said on the Order of Business when he brought to mind the simple parable of the good samaritan and asked whether in these kinds of conditions someone who found a man bleeding to death on the side of the road would, as they used to say about the American health service, first feel his wallet to see if it was still beating and then just look around and decide if there was an inhibition here to prevent him being helped for various reasons. Senator Brian Hayes asked a very pertinent question in wondering where this inhibition came from. It seems clear it did not come from a political source. It may have come from within the hospital. It is appalling and astonishing that a surgeon who intervened courageously to save life on a previous occasion was reprimanded and chastised. This is not a good indicator for the health service and these matters need to be clarified.

We also need to consider the insurance situation. We need to ensure that not only are those medical staff, who courageously intervene, covered and given political protection by being supported when they take such action in the line of their work, but also that they are not subject of the threat of enormous financial loss. For example, a surgeon might intervene in the case of a person who was already beyond saving. Then, as happens frequently in other jurisdictions, the well-intentioned surgeon is slapped on the wrists and taken to court. A few years ago in America a woman collapsed beside a swimming pool with a ruptured appendix. A doctor operated with an ordinary domestic knife and saved her life. Her grateful response was to sue him and receive $750,000. We must protect medical personnel against this kind of risk.

We should not use these matters to excoriate particular politicians, to hold them directly or personally responsible, or to score political points. We should have in mind the general welfare of the community. I welcome that the Taoiseach in the other House made it clear he would stand against these kinds of personal accusations by saying: "I will not accept that there should be political accountability every time a person dies anywhere in our health service." He is right and we, as politicians, on all sides should support him in this matter.

I remind the House that we are perishable goods. Death is inevitable. One hopes to accomplish it with the minimum of trauma or suffering. I am not referring to the situation of Mr. Walsh which is a separate business. Sometimes the impression is given in this country that people believe they are entitled to live forever; that if they get a cold the local TD is responsible; if they have an operation the Minister is responsible; and, if they die the Government should fall. This is not realistic. Our health service is not as bad as we make out. There are difficulties in delivery, there is appalling bureaucracy, there are too many managers and the Hanly report should be implemented.

On this I disagree completely with Senator Leyden who spoke from the Government side of the House and who attacked Professor Drumm. I say, thank God for Professor Drumm and his clarity, forthrightness, decency and honesty in addressing a situation. We should leave it to him and not attempt to interfere politically in the interests of our own little backyard. I am sickened by what I see on all sides of this House. Every party is involved. Every party wants to save its own hospitals but what they mean is they want to save their own seats. This is not about a hospital but is a popular voting issue that calls for people of courage. If the political leadership is not forthcoming from the political parties, then I urge Members not to attack people like Professor Drumm who know what they are talking about and have the experience. The Government should not waste its time appointing somebody with expertise if it will not listen to it. I agree it is a situation which needs discussion. Professor Drumm is perfectly correct in his view that one cannot have five hospitals with a huge range of expertise and duplication within a small area.

I remember the situation 30 years ago when the Minister for Education was giving lessons about the proposed university merger involving Trinity College. The argument was that duplication was not desirable and in some ways that was valid; it is certainly valid in terms of the delivery of hospital services. However it must be ensured that people can be brought rapidly from one hospital to another and that beds are available. There should be a computerised system to show where beds are available. There should be correct ambulance transport and properly trained personnel to ensure people do not die in ambulances. I urge the Government Members not to go against Professor Drumm and his courageous involvement and intervention in this matter.

There is clearly something wrong in the hospital system within this localised area. It is astonishing that this man was denied treatment in a hospital; it would be a different matter if he could not get to the hospital. Senator Brian Hayes referred to another situation where a person was denied admission to a local hospital. The staff of the referring hospital decided they could not bear the repetition of having to stand by and watch a patient bleed to death so they took it upon themselves to telephone the senior administrator of Cavan General Hospital who was in bed in the early hours of the morning. He instructed the staff to admit this man. Why did that have to happen? What is the ethos and where is the notion of the hippocratic oath?

I do not know if the oath was ever administered to doctors but it is something in the popular imagination, like the 1916 declaration about cherishing all the children of the nation equally. The public has the idea in its head that a medically qualified and trained doctor will do everything possible to keep people alive. It could be that this oath no longer exists but the ethos should. We should feel confident that if we are in distress or at death's door, at least a proper, civilised effort will be made to spare our lives.

We are all perishable goods, our time is short and we might as well get used to it. The best we can hope for is reasonable treatment and an easy passage out of this world because that day will come. We must be realistic. Our demands on the health service are increasing every day to totally unrealistic dimensions, particularly in the view of people of my generation. I remember when people would die of an inward pain and nobody quite knew what it was. People accepted the realities of life.

Realistic plans must be implemented. The Hanly report will improve the situation. If Professor Drumm states a modified form of the Hanly report is required then he should not be attacked politically but should be congratulated on telling people the truth. It may be difficult for politicians in their own constituencies to tell the truth but Professor Drumm should not be attacked for doing so.