Frances Fitzgerald (Fine Gael)

I welcome and thank the Minister for her attendance in the House today. I regret we do not have more time to discuss with her the many issues of the health service which Senators would like to raise. We should not have to request the Minister's presence in this House. We should not yet again have had to ask her to come to the House owing to deep-rooted and genuine concerns in respect of patient safety in our hospitals and health system.

As I stated earlier at a meeting of the Joint Committee on Health and Children during which the Health Information and Quality Authority presented its report, HIQA is undoubtedly a beacon of light. There is great concern about quality and standards in our hospitals and the care patients are receiving. There have been seven reports in the area of breast cancer care alone. The Minister said she welcomes that there have been inquiries and reports. One could equally say, however, that failure to deliver for patients on the frontline over a ten year period, a time of unprecedented wealth and the Celtic tiger, is the reason our services are in the state they are in and the reason these reports were commissioned.

I have referred already to services in respect of breast cancer care. However, if one looks at the spectrum of health care in terms of MRSA levels, over-worked staff, maternity services, cut-backs in community care, children at risk of not getting services — as reported on Friday last — and the closure in many counties of mental health waiting lists for children with effectively no service available for children with mental health difficulties, one could not be complacent but could predict the commissioning of many more reports on the current delivery of service to individuals in every region. Something has gone seriously wrong in the delivery of frontline services.

While I understand the vision outlined by the Minister, I must question her about delivery during the past ten years and during her tenure as Minister for Health and Children for the past three and a half years. The names add up to a tally of disgrace and betrayal for many people. I will speak in a moment about what the Minister for Finance, Deputy Cowen, said in the Dáil last week. Names that come to mind are Tania McCabe — Members will have seen the recently published report in that regard — Patrick Joe Walsh — we all know what happened to that elderly gentleman — Beverly Seville-Doyle's experience in the Mater Hospital, Peter McKenna, Susie Long and Rebecca O'Malley. Each of those names represents a person brutalised by the system of care he or she tried to obtain, each of whom was crushed by the system. While the Minister's words and the initiatives outlined are fine, the day-to-day experience of many people in our health service has been one of upset and death, deaths that should never have happened.

I am concerned that last week when Deputy Enda Kenny raised the case of Mrs Peg McEntee, the 76 year old lady left on a trolley in the Mater Hospital for 48 hours, the Minister for Finance, Deputy Cowen, did not apologise to the family for their ordeal but criticised Fine Gael for raising the issue and referred to the matter as facile. I do not believe patient care and safety and raising individual cases to illustrate the experience of many people is facile. I hope the Minister does not believe that and that she will say so. If she agreed with Deputy Cowen's statement she would then also be suggesting it is facile to raise the issue of the distress caused to the women given the all clear from cancer only to find out later the tests were unreliable and they had a cancer that was advanced due to misdiagnosis. These are emotional nightmares for the people concerned.

The Minister apologised to the women concerned and I have no doubt she meant it and that she felt deeply for them. However, that in itself, as the Minister has already stated, will not protect women from future errors. The Minister needs to outline for us the changes being introduced to deal with these situations. There have been many reports such as the Fitzgerald, O'Doherty and Doherty reports. Though there was no collusion between the authors, they all reached the same conclusions and listed problems in respect of governance, communication, delays in responding to patients' concerns and to what can only be described as general confusion among some staff in respect of their roles and responsibilities. I would like the Minister to respond to the problems identified in these reports which are compromising patient safety day in and day out. If people do not know what are their roles and responsibilities in delivering health services, how can they deliver them?

The Minister said in 2004 that we needed clarity of roles and accountability, political responsibility for the Minister and management responsibility for management. Has this happened? The reports clearly show nothing has happened three and a half years after that statement was made. Why is there confusion in respect of roles within the health service? Does the Minister accept that confusion and lack of clarity poses a risk to patient safety and damages the level of efficient care afforded to patients? The buck has to stop somewhere. We must know what action is being taken in respect of governance and accountability within the health service. Many of the reports have addressed this issue. The Minister needs to clarify it; it is not new but has been commented on in many reports.

I would like if the Minister could respond to Senators' concerns about the move to specialist centres. Let us take for example the closure of maternity services and the redirection of expectant mothers to other services——