Brendan Daly (Fianna Fail)

I thank Senator Feeney for affording me the opportunity to speak briefly on this matter. I support the reforms that have taken place and congratulate the Minister on the work she has done so far. Not only is reform under way in administration, a vital area, it is happening in budgeting and finance.

I would like to see more co-operation between the voluntary organisations that provide services and the Health Service Executive and the Department. In many cases, voluntary organisations provide facilities that the HSE could not afford. Kilrush Community Hospital is spending €1 million to install a kitchen but the estimated cost for the HSE to carry out the work was €4 million. The hospital could only secure some funding from the national lottery. There should be a lien in the financial arrangements so that community hospitals in places like Kilrush, Ennistymon and Raheen, which provide excellent facilities, do not depend on grants from the national lottery.

There are gaps in the system that must be bridged, such as when young people suffer from a stroke. The post-stroke facilities are almost inadequate, with people waiting months for treatment in the National Rehabilitation Centre in Dún Laoghaire. In the community and county hospitals, there are people in post-stroke trauma who should not be in acute hospitals but the National Rehabilitation Centre, where the staff do an excellent job, is so limited in its the facilities that people must wait four months before someone from the centre can examine patients in acute hospitals to assess their suitability for the centre. That is a major gap that must be filled.

Orthodontic treatment is in a chronic situation. We have been hearing about this for years on end and the situation appears to be getting worse, with more people on waiting lists and failing to get the required treatment, which causes further damage. In the allocation of resources to these areas, not only should the facilities be provided but there should be more training places for the occupation.

The Minister mentioned the impending dispute with the nursing organisations. This must be resolved so I send an appeal to the Minister and Minister of State to call in the negotiating organisations to resolve the issue before strikes start, with the resulting inconvenience to patients and staff.