Paul Bradford (Fine Gael)

I welcome the Minister to the House. We hear from her regularly and we are thankful for her attendance. Unfortunately the problems which she has come to address seem as if they are almost beyond repair and this is not politically acceptable. It is quite extraordinary that notwithstanding the huge economic boom and the significant investment across the length and breadth of the health service, we must report that two decades after the political sloganeering from Fianna Fáil about health cuts hurting the old, the sick and the poor, the cuts seem greater than ever, the service seems less and we have serious questions to ask.

When the Minister set in train the proposals to create the Health Service Executive as a new entity, I would have been a supporter. I saw the significant difficulties associated with the old system of the health boards. I had presumed the new system would be much more effective, cost-effective and efficient. I regret to say my judgment appears to have been misplaced. We now have a monster which appears out of control. The service to the public is certainly diminished and staffing levels have not altered in any sense. I note that a senior grade which formerly had six or eight persons now has hundreds of people at that level.

The taxpayer is investing enormous sums in the health service and he or she appears to be getting very bad value for money. Patients and the public are not receiving the service they deserve. The funding of the health service could be a subject for a broader debate. From a European and international perspective we are not spending the proportion of national income on the health service which is needed to put in place an improved system. I concede that the current level of expenditure is substantial but the taxpayer is right to ask where the money is going and the patients are right to ask where the service has gone.

I concur with my colleagues' fears about the outcome of the pharmacists' dispute. If I may be excused the use of a pun, I cannot prescribe a response. All we can ask for is dialogue. Whether it relates to the politics of Northern Ireland, Europe or any issue facing us, dialogue is necessary and important. We need to re-engage in dialogue with the pharmacists.

I wish to make some parochial points. I concur with Senator Buttimer's remarks about the Mercy University Hospital in Cork city. It makes very little sense that the public has spent so much money and the service is not available. The Minister will be aware of the excellent hospital in Mallow which last year was given the award for the cleanest hospital in the country. There are grave fears in Mallow about the future of the hospital. No one seems to be in charge of the budget or of making decisions fundamental to keeping Mallow as a positive general hospital for the town and the north Cork region. I extended an invitation to the Minister to visit the hospital to see at first hand what a small hospital can do effectively and efficiently. I again ask her to consider a visit to a hospital such as Mallow in the near future.

I apologise for straying beyond the issue of patient safety but this debate will need to continue because it is the biggest issue facing the public in this post-Celtic tiger era. Where has the money gone and how do we plan for the future to give the public a service to which it is entitled?