Pearse Doherty (Sinn Fein)

The theme of these statements is patient safety. I believe the biggest threat to patient safety is the grossly inequitable nature of the health service presided over by the Government for the past 11 years. Patient safety is the biggest issue of concern for everyone and the biggest failure of the Administrations in which Deputy Harney has served as Tánaiste and Minister for Health and Children.

There is a tendency to personalise the issue and target the Minister, as if she were solely responsible. That is very convenient for other Members of the Government, especially the Fianna Fáil Members. They, too, bear full responsibility for the disgraceful state of our public health services and for the disastrous policies that have led us to this situation. The members of Fianna Fáil and the Green Party now hide behind the Minister for Health and Children, Deputy Harney, trying to dodge their responsibility for health services. The Minister in turn hides behind the Health Service Executive which is the most unaccountable quango and most monstrous bureaucracy ever established in the State.

We all owe a significant debt of gratitude to the late Susie Long and her family because she exposed the reality of the two-tier public private system. As a public patient she was denied timely access to a diagnosis that could have saved her life. She found this out when she talked to a private patient sitting beside her in a hospital waiting room. The Taoiseach and the Minister said the system failed Susie Long. This was not just an unusual error. This is the way the system is built. It is a public-private system of apartheid and the Minister, the Government and their colleagues are reinforcing it. They are pouring public money into privatised health and co-locating for-profit private hospitals on public hospital sites. We will never know how many Susie Longs there have been but there must have been thousands. These are the people who were denied timely diagnosis and hospital care and timely access to a range of services because they were public patients.

MRSA and other virulent hospital-based infections are major issues for patient safety. This was thrown into stark relief by the release of the first national hygiene services quality review by the Health Information and Quality Authority last November. It states that the majority of public hospitals need to improve their hygiene standards dramatically. The report states that just seven out of 51 hospitals have good hygiene standards while none was found to have very good standards. Nine hospitals were rated as poor and the remaining 35 rated as fair.

The HIQA states the findings show that most hospitals need to take measures to improve standards. The need for more single rooms and isolation units to combat MRSA was identified as far back as 2001, but no action was taken. Accident and emergency units and wards are under constant pressure and the highest standards of hygiene cannot be maintained. As a result of the privatisation of hospital cleaning services, the standards of cleanliness have not been maintained. Cleanliness and hygiene should be an integral part of every hospital's work, with cleaning staff employed by the hospital and part of the hospital team.

Sinn Féin calls for an effective national strategy against MRSA to be delivered locally in every hospital and nursing home and every other care setting. Patients must be fully informed when they have MRSA and deaths attributable to MRSA should be recorded by coroners. The prevalence of MRSA is one of the reasons the promised 3,000 additional hospital beds must be delivered. Single rooms and isolation units should be included in that figure.

On the pharmacy dispute, thousands of patients are concerned that from next Thursday they may not be able to get their medication. I ask the Minister, Deputy Harney, to outline plan B. I understand the Minister's plan B was to take these pharmacies to the High Court. However, many pharmacies have not responded and the deadline passed yesterday. Therefore the Minister's only option is to take these pharmacies to the High Court. If the Minster fails in the High Court, what will happen next Thursday? The option of Boots providing the service is unlikely as I understand it has informed the Minister that it will not be able to cater for the demand. In Donegal alone there are 55,000 prescriptions every week under the medical card scheme. I ask the Minister in terms of patient safety, what is the plan B that will assure patients they will get their medication after 1 May.