David Norris (Independent)

I propose to share time with Senator Hannigan. I welcome the Minister, who is very good in the way she attends the House. She cannot always be pleasant because there is usually a good dose of criticism.

I have always agreed with the idea of centres of excellence. There is a problem politically because people are subjected to intense pressure in their local areas to keep the local hospital despite best practice. Centres of excellence are important.

The question of transport must be examined but in a country this size the best treatment is the most important factor even though there are great inconveniences with regard to transport.

Educating the public and self-diagnosis is important. Professor Keane made the point that cancers which affect the throat and so on are particularly nasty. Sometimes they can be detected during oral hygiene and visits to the dentist. Unfortunately, many of the people who develop this kind of cancer do not go pay frequent visits to the dentist. There is a question of diagnosing and identifying so that it is not given inappropriate treatment.

I refer to the question of certification. There have been a series of problematic areas, including the midlands, where there was difficulty with proper diagnosis, understanding of medical scans and treatment. In the Canadian system, there is a certification process every year. The senior consultant or a higher authority issues a certificate for all doctors underneath him or her. This states that the doctor is fit to practice, has had no accidents or problematic areas and can continue for another year. That is excellent and we should do that, which would lead to greater patient safety.

If one wants to find out what works, one should examine the way people practice. I am interested in evidence that is a partly anecdotal but partly verifiable, namely, that doctors send their families to centres of excellence. Then, for political reasons, they will bellyache about the closing of the local cottage hospital. That is as immoral and wrong as politicians mixing it.

My final point relates to Roscommon. I voted "No" in the Lisbon treaty referendum and campaigned for a "No" vote. I was clear about the reasons for this, namely, bullying, opportunism, lack of democracy and the infractions in neutrality. I remember the people of Roscommon but that is not a reason to vote "No". It is the lowest form of politics to base one's campaign on some other issue.