Fergal Browne (Fine Gael)

A country as wealthy as Ireland should provide a far better service. The worst aspect is that members of the public seems to have resigned themselves to believing that nothing can be done. That is an indictment of all of us. Something can be done. I was in Taiwan recently, a country that has the same size population as Ireland, and it has no waiting lists. That proves it can be done. It has a different health system. I appreciate that we will never solve all the problems in the health service but the service should not be as bad as it is at present.

When Deputy Harney was appointed Minister for Health and Children, one would have thought she had been absent from the Cabinet meetings for the previous seven years when the health service was discussed. She appeared to imply at the time that she had little confidence in the previous Minister, Deputy Martin. Now, however, Deputy Martin seems to have been a better Minister than Deputy Harney, given her mishandling of the health portfolio.

It is almost impossible to get answers to questions about the health service. The Tánaiste attended a recent Fianna Fáil parliamentary party meeting at which backbenchers were complaining about the difficulties in accessing information on the health service. I was encouraged to hear this because I am conscious of it too. I was glad to hear Fianna Fáil backbenchers are having the same problem as their Opposition counterparts. Replies to Members' parliamentary questions take months. The Health Service Executive has a new service for Members that is slightly better but Members still find themselves constantly chasing answers. Often the replies are incomplete forcing a Member to resubmit another parliamentary question.

The freedom of information request facility is not working either. Last September I submitted a freedom of information request yet only received a half answer last month after 15 telephone calls. There is much frustration on both the Government and Opposition sides about accessing information on health services. A conspiracy of secrecy exists in the Department of Health and Children that does not enable us to do our job. Members are trying to find out the actual position of the provision of health services but the information is not forthcoming. If Members find that difficult, what hope do the general public have? This issue must be addressed immediately.

Several years ago, the Department of Social and Family Affairs had a bad reputation for replying to questions from Members. Now the Department is considered superb. Not alone will it give an answer in a few days, but it will provide a full answer. That is the same standard that should be expected from the Department of Health and Children.

I am glad the Minister of State followed the Fine Gael Party's Ard-Fheis along with the many thousands there and at home. Fine Gael is concerned at the privatisation by stealth of the health service by the Progressive Democrats. I am not a socialist but I am concerned at the privatisation of basic services. The direction of the health services is unsure. Cost analyses of public private partnerships have not been good, as friends in the Department of Finance have informed me for years. The use of PPPs in school-building has seen projects becoming more expensive and delayed. I challenge the Minister of State to go before the Committee of Public Accounts to put the facts before the Comptroller and Auditor General, Mr. Purcell, to ascertain if PPPs are good value for money.

The committee will soon conduct a cost analysis of the Kilcock-Kinnegad bypass. The contrast between the amount invested by the PPP company and its expected revenue from the high tolls it charges will be scandalous. I would be careful about going down the road of PPPs unless every detail has been worked out. Understandably the private sector gets involved in projects to make money yet certain services must not leave State hands. The sale of Eircom is a classic example. I challenge any Member to claim that Eircom is a more efficient service than it was in the past.

I recently requested information on revenue from charges for attending accident and emergency departments since 2000. The answer, which I only received this morning, was that revenue came to €3.5 million with €1.5 million outstanding. This could indicate the Health Service Executive's accountancy practices are shocking and it is not in charge of its brief. Alternatively, the Tánaiste is blatantly wrong when she claims people are in accident and emergency departments who should not be there.

The Minister of State claimed 3,300 people attend accident and emergency departments every day. The revenue figures show that in the past five years, €5 million has been taken in revenue by accident and emergency wards, some €1 million per year. The charge for attending an accident and emergency ward is €60. Using simple arithmetic, last year 25,000 patients who were eligible for charges attended accident and emergency wards. That stands at 500 private patients a week and 70 a day. When considered nationally, it appears only two patients per day, eligible for the charges, are attending each of the country's accident and emergency wards. Either the Health Service Executive's reply is wrong or the Tánaiste is incorrect when she claims people are attending accident and emergency wards who should not be there. I ask the Minister of State to investigate these figures as they seem amiss.

The Tánaiste agreed with me at a health committee meeting that the turnaround times for patients in accident and emergency wards are not known. A friend, a chef, cut his finger one day at work and needed to attend his local accident and emergency ward for what should have been a routine procedure. He was there for over 14 hours. After requesting information from the Department of Health and Children on patient turnaround times, I have discovered the information is not available. With the limited information the Department has, there are large variations. Some wards are quick in admitting and discharging patients while others are not so good. It is hard to compare health service provision in an effort to suggest improvement when this information is lacking.

I was given much information on the numbers of patients who attend accident and emergency wards and remain in hospital. The length of stays in Dublin hospitals, compared with other areas, has increased over the past several years. It suggests that work practices could be improved to achieve a greater turnaround of patients.

I recently requested information on the number of social workers for the elderly. I am still awaiting a reply. It is incredible that the Department knows how many social workers there are but not how many are specifically appointed to care for the elderly. I suspect many elderly people who attend an accident and emergency ward are not discharged because there is no backup for them outside the hospital. It is incredible the State employs people to do a job but it does not know exactly what they do.

The Tánaiste stated 29% of patients in nursing homes should not be there. She claimed the home care package of €150 million a year would allow these patients to be discharged back into their communities. Is there any indication of how many people have been discharged from nursing homes?

The Government always refers to 1997, as if the world was a dreadful place then. The economy, however, was going well with the State having its first ever budget surplus. More important, there were 500,000 fewer people in the State. Why then should the Government not claim it is increasing bed numbers when there are more people living in the State?

I note the Minister of State watched the Fine Gael Party's Ard-Fheis.