Jim Walsh (Fianna Fail)

I support the amendment to the motion laid before the House. This area has commanded a great deal of time in both Chambers of the House, rightly so. I note that the motion tabled by the Opposition places heavy emphasis on recruitment. Does this miss the point somewhat? I think the issues facing the health service relate to productivity and value for money and there are many reasons for this.

In the past ten years, the number of people working in the health service has increased from 68,000 to 111,500, and this may be mentioned in the motion. Expenditure has gone from €3.5 billion to €14 billion this year. There have been improvements in the health service due to increased investment, but it should be acknowledged that these improvements are not commensurate with the level of investment, which has been quadrupled.

The Minister for Health and Children, Deputy Mary Harney, has taken initiatives that will benefit the health service. In the previous Seanad, she ensured the person at the helm of the Health Service Executive, HSE, would be someone in whom she would have confidence. Aer Lingus saw a very positive transformation in its fortunes when it appointed one of its former pilots to the position of chief executive officer, CEO. Similarly, it was enlightened to place a consultant in charge of tackling shortcomings in the health service.

I understand the reasoning behind the abolition of the health boards and the introduction of the HSE, but the system could have been enhanced had tiers of accountability been built in. I made it known to the Minister and her predecessor that I felt we should have continued a system that saw boards appointed at regional level that would report to the national board, rather than from executive to executive. The latter system has corporate governance flaws because people in executive positions will tend to cover for each other and this has occurred quite a bit in the health service. I refer not just to the misdiagnosis, which we instanced earlier.

In many ways, the manner in which we dealt with the blood transfusion issue left a lot to be desired. Nobody was held responsible for what amounted to criminal negligence that saw many people suffer and die. Well paid positions in the health service involve a responsibility to do a job well and there must, therefore, be accountability. The Minister should examine this matter.

Payments made to people in senior positions in the health service have been criticised in the media and in this House today. I have been impressed with the initiatives Professor Drumm has taken since he was appointed chief executive of the HSE, but the jury is out on his performance and will remain so for some years until we see the improvements in the health service that we seek. To concentrate on bonuses he has received, however, is to miss the point. I do not believe the chief executive of any company quoted on the European stock market would work for the salary or bonuses he receives. Any person in charge of a service with a €14 billion turnover deserves to be paid accordingly because he carries a great deal of responsibility. He should be judged by his performance, not by what he earns.

I was recently appalled by the story of Susan Long and I am sure the Minister and everyone in the House shares my sentiments. Accessibility is required in the health service and I admire the manner in which the Minister is approaching negotiations with consultants. For too long public services in this country have been controlled by people who benefit significantly financially despite shortcomings in the service given to patients, although many others do excellent work. Whatever happens in the negotiations with consultants, there should be no compromises that result in the patient being anything but the primary focus. People working in such areas of the health service must understand that it is not a nine to five office job. They must accept that if cover is not provided for essential public services around the clock, we will not meet the demands of patients.