David Norris (Independent)

I do not like the public versus private model. It was appalling that the woman in County Kilkenny was sentenced to death for the crime of being poor, which I have said before. That is my principled stand. I find there are elements with which I agree on both sides of the debate. For example, regarding step No. 4 in the motion, I agree with most of what the Labour Party put down, but I do not agree that each hospital and each community care area should be given autonomy to spend its budget. That is madness and will lead to NIMBY syndrome. Everyone will want their own hospital and I do not believe it will work in that way. We must have centralised control.

There are concerns, however. I listened to a very distinguished professor on the radio and he said that he could have been an adviser and made money out of continually advising on re-organisation of the service. However, he went on to say, continual re-organisation would involve throwing money at it all the time, but there would be no increase in service delivery and we must face the existing problems. That is the reason, I believe, step No. 2 in the Labour Party motion, namely, making it clear that the Minister for Health and Children is responsible to the Oireachtas and appointing a named officer which may be the Secretary General or may be Professor Brendan Drumm, is a way forward that is useful. I do not believe the proposal is answered by the bland waffle with which the Government responds. The Government has said these officials are already responsible which is not an answer to a direct and specific question. That is what is wrong and it is the reason I will vote with the Opposition.

There are so many problems. I had a woman who campaigned for specific medical treatment to be made available. That was agreed. Managers were appointed and, at that stage, the Civil Service recruitment freeze was imposed. There was no medical staff, no delivery of services and the HSE is left with the managers and is still paying them. That is the reason step No. 3 of the Labour Party motion proposing an offer of voluntary early retirement, redundancy and re-deployment scheme is vital to progress. However, it must be focused, cut out the flab and get rid of surplus people. There is no point getting rid of the people who deliver the service. We must go further in our efforts, focus on change and make clear where it should be.

Regarding step No. 6 which says that each hospital and community care area should be required to establish a patient liaison programme and so on, it quotes a specific case which is one of the problems. We all find these heart-wrenching individual cases. However, I do not believe we should endlessly regurgitate them.