Ciarán Cannon (Progressive Democrats)

This Bill is a testament to the thorough and prudent approach of the Minister for Health and Children, the Government as a whole and the Office of the Attorney General. The normal work of government involves ongoing legal analysis of how current primary and secondary legislation is being used to implement policy on a wide range of issues. As the Minister has said, the primary legislative basis for funding the new national paediatric hospital, which is to be developed by the HSE, was analysed in the normal way. The Minister, Deputy Harney, has confirmed that arising from those considerations, the Office of the Attorney General decided in mid-October that a more fundamental review of the constitutional status of the health Acts needed to be undertaken. The Minister was advised on 26 October that the legislation being considered today was needed. I do not accept that there has been a delay since then. Any fair-minded person who examines this legislation will see that considerable work has been done quickly to produce a Bill that will make technical amendments in a number of areas. This Bill will set a proper modern standard for the legal underpinning of various health bodies. I congratulate the Minister, the Office of the Attorney General and their officials on the work they did to address this issue as soon as it was identified.

Most of those who have spoken during the debate on this Bill today and yesterday have glossed over the considerable and valuable work that has been done. Some Senators have preferred to focus on the issue of co-location. I am pleased to have an opportunity to remind Senators of the benefits of this policy initiative. I have the utmost confidence that co-location will be proven to be in the public interest in every respect. Public representatives have been asking for years for new acute hospital beds to be provided more quickly. It has taken many years to complete certain major hospital projects, at a time when great progress was made with other construction projects in the private and public sectors. The co-location initiative will free up 1,000 new public beds over the next three or four years in a cost-effective and efficient manner. It has been scrutinised and tested by numerous legal and financial advisers, including officials in the National Treasury Management Agency and the Departments of Finance and Health and Children. We already have public and private health care providers in this country, including within our hospitals. There are 2,500 private beds in public hospitals. These are not available routinely to public patients in the same way as to private patients, despite that taxpayers' money built them and continues to fund them. Is it not time we changed this? It is time at least we made a start. I cannot believe people would still argue it would be best to leave things as they are with no reform whatever. Co-location will free up 1,000 of these beds. This means a massive and, more importantly, rapid increase in hospital bed capacity for public patients. It is a significant step towards ensuring our publicly funded hospital capacity will be used solely on the basis of medical need.

We already have a public and a private system. That will not change. Neither is there much demand for a monopoly of public health sector provision. There is no case for that. All the trends internationally are towards using a diversity of health care providers, public, private and voluntary. The real task ahead is to make public and private work together in new ways to provide more capacity and better health services. That is exactly what co-location will do. Public and private health care providers will work together as never before. As the Minister has said, we will be able to use the new privately managed facilities for public patients to supplement, rather than supplant, public services. We already do this with the National Treatment Purchase Fund, which has systematically opened up the gates of private hospitals to public patients. It gets on with the job of buying treatment for patients.

Let us be honest. Patients do not care who runs or finances a hospital as long as the care is good and they are treated without long delays. The Minister is right, and in agreement with most patients, in saying that all hospital capacity that meets standards and offers value for money should be usable by all patients. She is also right to insist that under this policy and the new consultants' contract, access to publicly funded care must be based on medical need alone. She is passionately committed to this and, as we all can see, she has the full backing of the Government side in this House.

There are, none the less, constant and sometimes vicious distortions of her motives and commitment to equity in the health services. Some people wilfully ignore her spoken words, repeated many times on the record, and claim to know better than she does herself what is in her mind. It is happening again today. This cannot be explained away as normal politics or fair commentary. It goes well beyond that. The Minister is a better woman to ignore it, as she does. I am confident, as is the public, that she is totally focused on achieving what is fair and best for all patients. Anyone who knows Deputy Harney knows that.

There are Members of this House and others who accept the Minister's motivation but still query the co-location policy. I invite them to examine it again in detail and consider the real protections of public interest set out by the Minister yesterday in the Dáil. She stated, for example, that there would be only one accident and emergency department on each site. She also stated that the co-located private hospitals would facilitate medical training and research and development, accept direct admissions to medical and surgical units from primary care centres and general practitioners on a 24-hour, seven-day basis, comply with physical design requirements to fit in with the existing public hospitals, and share clinical governance, information, records management, performance management provisions and documented service level agreements with the existing public hospitals where these are undertaken. They will participate in the public-hospital inpatient inquiry scheme and case mix information systems. These are all new developments and new ways of ensuring public and private hospitals work together. For all these reasons and others, the co-location policy will deliver real benefits to our health services and, for many years to come, provide a platform for further ways in which the public and private sector can work together for the benefit of all patients. I commend this Bill to the House.