Liam Twomey (Fine Gael)

If the Government is serious about this, it should focus on reforming the public service and making it work. The Minister and I had many discussions on the consultants' contract. I got a lot of grief from some of my colleagues in the medical profession, as long ago as January 2006, when I backed the Minister's approach to this issue. I suggested to her that if agreement could not be reached on the contract, she should bring in her own contract. I proposed at that time that a deadline of Easter 2006 should be put on it. Negotiations on the contract have not yet been concluded as we approach 2008, as a consequence of the Minister's failure to do anything about it. The Minister needs to reform the public health care system by making changes which will ensure that porters no longer refuse to take patients to X-ray departments, for example. We need to ensure that nurses cannot refuse to treat a patient because he or she is not in the ward to which they have been designated.

The Minister knows in her heart that the administration of the health service is a disaster. These problems are caused by the Government's failure to implement the necessary changes to the manner in which the €15 billion is spent. The Minister has opted out of the reform process, preferring instead to get taxpayers to pay for the establishment of private hospitals on the lands of public hospitals. Everyone knows that is not the correct policy. Fianna Fáil Ministers seem to have a huge difficulty with this. Senator Feeney seems to have conveniently forgotten that two days before this year's general election, most Fianna Fáil Ministers had no idea how much co-location was going to cost. That is the problem.

Some of the Government's health policies are contradictory. It intends to build private hospitals next door to public hospitals. I do not want Senators to think I have something against private hospitals, because that is not the case. I am happy to refer my patients to private hospitals, as long as I am satisfied that the standards in those hospitals are acceptable. I have a problem with the private and public sectors being mixed so closely together, because I know what will happen in the long term. It will not be good for patients or those who pay for the health service. I will spell out the contradiction to which I referred. One of the major Bills to be debated in the Dáil before this year's general election was the legislation that established the Health Information and Quality Authority. The staff of the authority are not allowed to go into private hospitals. When things go wrong in the private hospitals which are to be built next door to public hospitals, the authority will not be able to investigate. It will be able to go into public hospitals but not private hospitals. The Minister has said that public and private consultants will serve both types of hospital, although those of us who know what really happens in the health service think they will spend most of their time in the private hospitals. The Health Information and Quality Authority will not be allowed to go into private hospitals to find out what is going on there. There is a complete lack of clarity in relation to how the health service is supposed to work.

If Fianna Fáil Senators want to examine these matters some more, they should consider the Government's failure to put in place a consultants' contract that serves the Irish people. They should ask why the Health Information and Quality Authority, which is supposed to be able to protect patients in health institutions, is not able to go into private hospitals. They should try to explain why they accepted such a daft notion in the first place, instead of reforming the public health system in a way that will ensure it works for patients. The Minister has brought in Professor Drumm and Professor Keane for a few nice press conferences. A few media commentators have said she is a "can-do" Minister. I hope that is the case, but the time for dealing with these big issues is running out quickly.

The Minister cannot just pay the consultants what they want — she must make reforms to the public hospitals so they work for patients. Too much money is at stake to do otherwise. More importantly, lives are at stake. I ask the Minister not to blame the HSE simplistically for the problems which have been encountered over recent months. Many of the problems have been built into the system by the way the reform process has gone so far. I am afraid that process will not be successful in the future unless we are quite serious about what we must do.