Brendan Smith (Cavan-Monaghan, Fianna Fail)

I thank Senators Prendergast and Fitzgerald for their contributions. The intention of the amendment is to delay the commencement of the provision inserted in respect of the establishment orders for St. James's Hospital and Beaumont Hospital which is designed to put beyond doubt their capacity to enter into co-location arrangements. As the Minister, Deputy Harney, pointed out on Second Stage last night, the co-location initiative has been Government policy since July 2005. It is not a new policy or one the Government is trying to introduce by stealth. It has been the subject of debate in this House and in the Dáil on a number of occasions. It was one of the central planks of Government health policy that was put before the electorate at the general election some months ago.

The principle underlying the co-location initiative is simply to free up capacity for public patients and ease the pressure on waiting lists in accident and emergency departments. The initiative is founded on the principle that all patients ordinarily resident in our State should continue to have access to public hospitals. However, access to public hospitals should be based exclusively on need. Possession of private health insurance should influence neither timeliness of access or treatment regime. Co-location will help to bring about more equitable access to public hospitals and will redress the current imbalance in favour of private patients. Co-location will free up approximately 1,000 beds for public patients through the transfer of private patients to the new co-located hospitals. Co-location is the quickest and least expensive means of providing this additional capacity for public patients. There will be no direct capital cost to the State and the revenue costs will be minimal as the beds in question are already fully staffed and funded.

The boards of St. James's Hospital and Beaumont Hospital and their medical staff were not forced into co-location. On the contrary, both hospitals were developing plans for private hospitals on their respective sites before the co-location initiative was developed. The two hospitals are anxious to pursue the co-location initiative and I understand the advice they have received from their lawyers is that they already have the legal capacity to do so. However, the view of the Attorney General is that the case is arguable. These provisions have been included so that there would be no doubt as to the legal basis of the arrangements in the two hospitals. I do not see any benefit in delaying the introduction of the provisions.

The Minister, Deputy Harney, has consistently made the point that when the Bill is passed, no further orders can be made in respect of these bodies. The Attorney General has advised clearly, and his advice is privileged and cannot be released. Ministers and their Departments must abide by the advice of the Attorney General, the Government's legal adviser.

As has been stated on a number of previous occasions in this House, in the Dáil and in other public fora, the land and public hospital sites to be used in the development of co-located hospitals will be leased to the private partners. The public procurement process has proceeded on that basis and the private partners are well aware there is no question of the land being sold to them. The land for the co-located hospital at Beaumont is owned by the hospital board whereas the land at St. James's is owned by the Health Service Executive and is leased to the hospital board.

The phrase "disposal of land" in Article 4A(2)(b) was the subject of detailed discussions between officials of the Department of Health and Children and the Parliamentary Counsel. The advice of that office is that the language used in Article 4A is the appropriate formula regarding dealings in land. The land for co-located hospitals will be leased and Article 4A is designed to permit this and no more. Therefore, I do not propose to accept the amendment.