Liam Twomey (Fine Gael)

This legislation is quite straightforward. The only surprising thing about it is that it took so long for this work to start. The Prospectus report which was published in 2001 or 2002 discussed rationalising services and agencies in all areas of Government. Deputy Micheál Martin, the then Minister, has the distinction of managing to set up the largest number of agencies while he was Minister. We are now dismantling many of them. The International Monetary Fund, IMF, has said it had little confidence in the Government in this country between 2002 and 2007 and alluded to the setting up of agencies to deal with everything and anything.

Many of the agencies we are discussing today are incredibly good, and it is important the corporate memory of each is not lost when they are subsumed into the HSE. The Government needs to move a little quicker to deal with the many other agencies, bodies and groups it established over the last decade which appear to serve little function when compared with the agencies being discussed in this legislation. Perhaps the Minister in her reply will discuss the corporate memory of these agencies. Once the agencies are subsumed into the HSE their employees will become like any other employee of the HSE and might find themselves transferred or moved around. There is also the issue of the ethos of a good organisation. The national cancer registry has a great ethos, is very well run and delivers great results. One can rely on the registry; it is impartial and its results are accurate and can be quoted in comfort. The crisis pregnancy agency has not shrunk from its responsibilities and often receives negative media coverage from certain vested interests that do not agree with what it is doing.

On the other hand, there has been a litany of corporate disasters in the HSE. It responds to criticism by either trying to bury or cover up the problem or by misleading the public on what has gone wrong. I am concerned that the negative corporate memory that has developed in the HSE would seep into some of these agencies and that the information they produce would be tampered with, altered or changed to present the Government of the day in a more favourable light or that they will shrink from making difficult decisions or implementing difficult policies simply because they might be told to do so, not necessarily by a politician or Minister but by senior managers within the larger organisation.

There is a problem with the senior management of the HSE. Many people do not quite know what we mean but there is a serious problem with how senior management makes decisions, implements those decisions and shrinks from taking responsibility for crises in the organisation. I have mentioned the Leas Cross report previously and I thank the Minister of State for providing me with a reply when I commented on that report. When the Leas Cross report was published its release was delayed for months because every individual mentioned in it was given the right to reply. The replies from some of the senior members of the HSE were an exercise in self defence and passing the buck. They never accepted the responsibility that they might have had a part to play in what happened in Leas Cross. Although I fully support rationalising and getting rid of some of these quangos, my greatest fear is that the agencies that were doing a good job will become like the HSE when they get sucked into that organisation. If that happens, they might as well have been abolished. They will become another group of employees pushing paper and getting shot down by senior management whenever they come up with a good idea that is considered controversial or difficult. I hope that does not happen.

Every agency of the State, including the Cabinet, should put the quote from the Ombudsman, Ms Emily O'Reilly, over the door of its organisation. She said: "Public bodies and agencies begin to go bad when they begin to lose sight of why they are there in the first place." It is an excellent quote. Agencies and organisations are established with the best intentions but as soon as they allow internal or external politics or the criticisms of vested interests to intrude, they cease to function in the way that was expected when they were established. We see this all too often. The problem has become worse in the last number of years and especially since the Freedom of Information Act was dismantled to some degree by the Government.

There is always an element of secrecy within an organisation, whether it is a small private sector business, a big organisation such as the HSE or even politicians. However, it has become all-pervasive in the sense that we try to bury every piece of information. We have killed transparency and accountability to an extent because we are not prepared to accept any form of criticism or accountability when something happens. It has worsened over the last decade. The IMF spoke about the problems with Ireland's economy and poor Government policy making. The Governments led by Deputy Bertie Ahern contributed hugely to that secrecy, which has been very bad for the public sector and the Civil Service. Many of the people who work in organisations in the public sector and in the Civil Service should fight back to secure their autonomy.

I said previously on the Order of Business that what the Governor of the Central Bank did on the day of the local and European elections was nothing short of a disgrace. He started to talk about the green shoots in the economy although he clearly knew everything we now know about the regression of our economy, rising unemployment and the mess of our public finances. He knew all these factors and was clearly trying to manipulate a result. Even if he denies that charge he should have had enough cop-on not to have issued statements of that kind on the day of an election. Even if he was completely innocent he should not have said such things because I and others like me will see his speech for what it was, as being far too political for somebody of his stature and with his role in Irish society. This attitude appears to have percolated through the civil and public service in such a way that people are no longer prepared merely to say things in the way they are supposed to, making themselves less political. This issue will become very important. The HSE has become too political and because these kinds of organisations are being subsumed into it there is a genuine fear they may lose their independence and the good corporate structure they have had for so long. When the Minister of State is discussing such matters in the Department perhaps she should be a little bolder and decide not to subsume the people and the organisations.

Perhaps it is time to look at the role of the National Treatment Purchase Fund. The NTPF has been great for the approximately 50,000 people who received procedures under it but it has added very little to the overall health care of this country. It is a private organisation set up by the Minister for Health and Children, Deputy Harney, to try to show the private sector as something special. What should have taken place during the lifetime of the NTPF was significant and serious reform of the public health services to make them more efficient and work better. The funding for the NTPF should have been used in that way. During the NTPF's lifetime, the health services in Northern Ireland experienced much the same problems as those in the Republic. Theirs were not as bad because more resources have been put into the national health service for a longer period but they were similar. When the services in the North set out to deal with those problems they did not seek the solution of diverting money towards the private sector but set up small groups under clear ministerial direction. These were not quangos but were very much the responsibility of the respective Ministers. They dealt with many of their problems in a very effective way, using public resources and delivering for the public.

In recent years when money was sloshing around under this Government - a false economy as we know now - we did not tackle the very serious problems in the delivery of health care. It is amazing that only one third of our people are entitled to free primary health care services, namely, free access to a general practitioner, and they must pay €100 per day for hospital services. It costs every taxpayer approximately €3,000 to deliver that service, but north of the Border people have free GP and primary care, free hospital care, delivered and achieved. This is not an ideological point but is about getting the best value for money and being able to deliver for the people whom one is supposed to serve. Perhaps the Minister of State should begin considering whether the days of the NTPF are over and whether we should focus on delivering and working and making the public health service work for the country. When the Minister of State replies perhaps she will give an indication of how much she expects to save when this legislation is passed and the changes are applied.