Liam Twomey (Fine Gael)

The problem with these types of debates is that Government Members have to support the Minister no matter what happens and regardless of the chaos in our health services. The road to ruin is paved with good intentions. That adage is appropriate when one considers some of the developments arising from the establishment of the Health Service Executive. I do not blame the Minister, Deputy Harney, for most of these problems. It was her predecessor, the current Minister for Foreign Affairs, Deputy Martin, who is responsible for the mess in which we find ourselves.

The setting up of the HSE was a rush job from the beginning. Most of those responsible for that process were concerned it was happening too quickly. However, the then Minister, Deputy Martin, wanted the executive to be up and running on 1 January 2005 for the purposes of public relations spin, knowing he would be well gone from that office when the true extent of the mess became apparent. It is interesting that when people were being recruited to head up the directorates within the HSE, nobody in the private sector in this State — which boasted, at the time, the most successful economy in the world — was considered adequate to run any part of the HSE. All of those who secured senior positions were previously employed in the former health boards. Within 12 months, however, half of them had either resigned from their roles or were moved because they were found to be incompetent.

The management structure of the HSE, as announced on 1 January 2005, had been already amended by 1 June 2006. By 1 June 2007, the structure was being amended again in line with the original formation as at 1 January 2005. I do not know what the situation is now. This constant state of flux is causing problems for staff further down the line, including those in local and middle management who do not know to whom they should report. That sense of incompetence at the senior level of the reform process means that problems with the delivery of services are inevitable. No matter how good the staff in middle management and in clerical and front-line roles, these problems lead to inefficiencies and wastage of resources. That is what this motion is about. The management structure of the HSE must be changed in order that the organisation can work efficiently.

The Minister, Deputy Harney, has given inadequate policy direction. She made reference to Dr. Donal Hollywood in connection with the cancer strategy report that she claims will lead to great improvements for patients. Dr. Hollywood produced a report on radiotherapy services to which the Minister reacted badly when it pointed out the mistakes that were made. However, perhaps she was big enough at least to acknowledge that she was not as wise about radiotherapy services as she should have been and that it was a mistake to wait five years before changing policy in this area.

The Minister is now saying we must restrict the number of facilities offering cancer care services. At the same time, however, the Government is offering tax breaks to small operators for the purposes of setting up small clinics at any location throughout the State to provide the types of services we were told should be provided only in centres of excellence.

I regret I do not have sufficient time to make all the points I wish to make. Will the Minister of State, Deputy Barry Andrews, ask the Minister, Deputy Harney, what has become of the Tribal Secta report which was published in January 2006? Where are all the great improvements we were told would flow from that report?