John Ellis (Fianna Fail)

I did not interrupt the Senator. She was the one who drew the fire so she should take it when she draws it.

People in this country are entitled to the best diagnostic service and treatment. If this can be delivered through centres of excellence, we must accept it. However, there is a role for hospitals like those in Sligo, Castlebar and Letterkenny when it comes to the further treatment and monitoring of patients after diagnosis and initial treatment, which should be pursued.

I cannot understand why some people say that it is now impossible for somebody to get to and from Dublin. I agree with Senator McFadden that there are people who do not have cars but services are being provided by the HSE in all areas. In the area I represent, the HSE will bend over backwards to ensure that somebody gets the service to get them to and from Dublin. I do not know what the story is in respect of the area covered by the former Western Health Board. I can only speak for the one with which I mainly dealt, namely, the former North Western Health Board area which still provides an excellent service to patients going to and from hospitals.

What annoys me is the fact that certain people shout for local hospitals but when it comes to treatment, they go to either the Blackrock Clinic or some of the other private hospitals in the country. This is something about which none of us wants to be hypocritical. I, like many people, pay VHI but if people do this, they will use it to the full. It is imperative that those who do not have the benefit of VHI cover get the same level of care as those who pay for private health insurance. If this is by means of the provision of centres of excellence, then that is the way we should go.

What also annoys me is the fact that some of the people who are most vocal in some of these protests have first-class VHI cover and, in many cases, will not use the local hospital. We all know that. Some believe that those who do not have health insurance should have a lesser service than those who can afford to pay for it. This is not the way the HSE or others operate. Let nobody try to tell me that we should have a three-tier system because that is what some people would like to see. I want to see the best diagnostics and surgical treatment provided to patients. If the local hospitals are in a position to do the monitoring work as people's treatment progresses, then that is the role they must play. That will not please many people but if we are to have perfection, one must have continuous work in the field in which one works and this is what the centres of excellence will do. I pay tribute to the surgeons in regional hospitals who do excellent work. It is unfair to expect them to perform across every discipline, from cancer to other surgical work. That is why there should be specialist surgery.

There are a certain number of hospitals that will carry out cardiac surgery. Everyone is happy with that because they know that going to see the senior cardiac surgeons means they will get a service that is second to none. Oncology should be the same. While people may feel aggrieved, they must consider who must be looked after most, the patient. If a family member was ill in the morning, we would be prepared to go to the end of the world to ensure the best possible treatment. That is why we have a role to play as politicians to ensure people get the best service. It might not be the most convenient service but we want the best possible service.

On radio yesterday, the famous professor made it quite clear that there were sufficient funds in the health service of this country. In some cases he felt there was waste on some treatments and the amount of professional time used by surgeons to monitor people who could be monitored as well by the local general practitioner or cancer nurses. These are the people who are being dragged back to clinics on a regular basis after full treatment and cure. They are taking up consultants' time. I felt both for and against this because if someone has been seriously ill he or she would like to continue to see whatever doctor dealt with the illness.

Many of the motions before this House are not aimed at the patient but at making political capital. This is not in the best interest of patients or the communities we serve.