Geraldine Feeney (Fianna Fail)

I move amendment No. 1:

To delete all the words after "Seanad Eireann" and substitute the following:

"—supports the fundamental objective of the Government in health policy, that is, the achievement of best clinical outcomes for all patients throughout the country;

affirms its confidence that this objective is best supported by setting national standards and applying them consistently; by the establishment of the Health Service Executive, HSE, as a unitary national health authority; and by the effective use of resources for the benefit of patients and service users;

endorses the many confirmations by the Minister for Health and Children that she and the Government fully accept political accountability for the health services and affirms that this is the position in the Health Acts;

welcomes the review under way in the HSE of its internal organisation structure to improve the effectiveness and efficiency of the organisation, by streamlining its management structures, clarifying roles, responsibilities and reporting relationships and strengthening co-ordination, governance and accountability;

acknowledges that a voluntary redundancy scheme for staff of the HSE would best be implemented in the light of the outcome of that review, in dialogue with the relevant staff representative associations, and with the potential for redeployment of staff having been fully identified;

underlines the importance of the statutory requirement on the HSE to manage its budget within its approved Vote;

supports management actions within the HSE to allocate and manage budgets at the appropriate hospital and community service levels;

affirms the importance of management accountability within the HSE for its own sizeable budget and expresses its confidence that this objective is supported by the chief executive officer of the HSE being the statutory Accounting Officer in relation to the appropriation accounts of the Executive;

acknowledges the steps taken in the Health Act 2004 to provide for and encourage local responsiveness of the HSE; and

welcomes the recent initiative taken by the Minister for Health and Children and the HSE in encouraging greater patient involvement in a wide range of health services."

I, too, welcome the Minister to the House. The Health Service Executive was established in 2004, before the Minister's time in office, under her predecessor, the Minister, Deputy Micheál Martin. In budgetary terms it is an enormous organisation with a budget in excess of €15 billion. The HSE is the biggest organisation in the country and everybody would agree it is a work in progress rather than a finished article.

There are approximately 112,000 employees in the HSE. The complexity of dealing with the nation's health needs is frightening, to say the least, and in the past year an enormous amount of the HSE's time has been taken up dealing with the well-entrenched elites of consultants and pharmacists. It appears that agreement is slowly being reached in both cases, which I welcome.

We all know the HSE is not perfect, and the system is not perfect either. We all have our own particular gripes, whether it is specialist centres of excellence for cancer care or overcrowding in accident and emergency departments. We must give the HSE, under the management of Professor Drumm, time to improve those areas. When considering this issue earlier today I made a reasonable analogy and compared the health services today with the progress of a supertanker. The latter cannot suddenly stop and turn in a small area, and an organisation as large and as complex as the HSE cannot be asked to do the same.

I was interested to read in the medical supplement in The Irish Times yesterday a short piece outlining a lecture held in Dublin City University on Monday night on information systems in health planning. Professor Anthony Staines, who is a professor of public health in DCU, referred to he and his colleagues coming together last year and issuing a report that found that public satisfaction with the HSE is much greater than the perception given in the media. It is easy for the media to ignore good news. Professor Staines stated that the reason it is ignored by the media is because it conflicts with their master narrative. Bad news is always better than good news. Sensational headlines are what is important to the newspaper business.

The common finding throughout Europe was that most people in Europe are happy with their health services. Professor Staines went on to state that if we were to abolish the HSE it would be disastrous for us as a nation and it should be stoutly resisted. If we consider the experience in the United Kingdom with the NHS, it found that changing such structures can often be counterproductive and paralyse the staff for several years while changes take place.

It is wrong of Members to come into the House and criticise an organisation such as the HSE without giving any consideration to the staff who work in it. I have family members working in the service and they tell me they are often embarrassed to say they are working for it. They put that down to the media bashing the HSE is getting currently. They are proud of where they work but they get embarrassed when they read the way they are perceived by the media.

I wish to highlight two points in the amendment. It states that the Government welcomes the review under way in the HSE of its internal organisation structure to improve the effectiveness and efficiency of the organisation by streamlining its management structures, clarifying roles, responsibilities and reporting relationships and strengthening co-ordination, governance and accountability, while at the same time acknowledging that a voluntary redundancy scheme for staff of the HSE would best be implemented in the light of the outcome of that review, in dialogue with the relevant staff representative associations, and with the potential for re-deployment of staff having been fully identified. Regarding what Senator Alex White said earlier, overstaffing is being addressed in the review under way. He would know that if he had read the amendment to the motion.

A national organisation such as the HSE is preferable to the old health board system. Modern research and science tells us that certain health treatments and services must be provided on a national rather than a local scale. Similarly, negotiations with health service providers, whether they are nurses, doctors or pharmacists, must be dealt with at national rather than local level.

We all know the problems families face, and they were discussed in the House some months ago, with the treatment and education of children with conditions such as autism. Again, the improvements we make in dealing with those problems will be better if dealt with nationally rather than locally.

As a nation we are living longer and are now healthier than ever before but as we age our medical needs become greater and more costly. That is an enormous challenge for all western countries, including Ireland. Given the limits of our national finances, we are particularly sensitive to that. I believe in a national organisation such as the HSE providing our health care. I am not naive enough to believe everything the HSE does is perfect or even acceptable in some cases but I reiterate that the HSE is the equivalent of a child in its early days in education. It is work in progress and it must be given the necessary time. I refer again to the points made by Professor Anthony Staines, the expert in the field of health planning.