Jerry Buttimer (Fine Gael)

I welcome the Minister of State and his officials. I remind Senator de Búrca that the Fine Gael Party is in favour of greater efficiencies and creating better value for money, be that in health or any other sphere of the public service. However, we will oppose and resist the issues causing legitimate concern to many organisations and people with regard to the quality of service for patients. People matter. It is extraordinary, given Senator de Búrca's contribution, that the Green Party has now become so embroiled in Government and so subsumed into Fianna Fáil that we might see them as one entity before the end of this Dáil term.

To deal with the Bill, it is important that we preserve the function of the agencies. They cannot be allowed to disappear within the HSE or the Department of Health and Children, or simply evaporate. I note the lexicon of the HSE now includes "reconfiguration" and "rationalisation". In plain language, this means the elimination and reduction of services. I am fearful we will have a loss of autonomy and a loss of policy-driven focus in these agencies so it is important we safeguard their functions and roles. What review mechanism will be in place to ensure the policies and functions of these agencies are implemented? The Minister of State might respond to this question.

I have grave reservations about the subsuming of these five critical agencies. Although it looks good on paper and reads well, if one goes through the functions of all the five agencies, there is a genuine fear they will get lost within the HSE or the Department of Health and Children. One of the issues I have with the HSE is that it has become a superstructure, which none of us envisaged when it was created. There is very little accountability and a democratic deficit. If one puts down an Adjournment matter, it is often deemed not to be the responsibility of the Department, but one cannot question the HSE on the issue.

Mental health is rightly becoming a central part of the health services. An all-party committee was set up yesterday, on which I commend Senator Fitzgerald and the Minister of State, Deputy Barry Andrews. I have a concern with regard to the Mental Health Act and I am not reassured by the Minister of State's contribution. The agency that carries out involuntary admissions for the HSE has worked well up to this point - there is no argument about that - but there are no ministerial regulations or protocols governing how it carries out its duties. The section would be more appropriate in a mental health Bill because it would benefit from an expanded explanation in a separate Bill. I look forward to the Minster of State's reply in this regard. I emphasise that there should have been a separate Bill purely to discuss mental health and mental health services.

In the context of women's health and the national cancer strategy, like Senator Coffey, I want to raise a core matter with which I have a fundamental issue. It concerns the insistence on the policy of the Government and the HSE with regard to the transfer of breast cancer services from South Infirmary-Victoria University Hospital to Cork University Hospital. This is a fundamentally flawed policy. Nothing that has been said in Adjournment debates or parliamentary questions, or by the HSE, has changed my mind or the minds of expert specialist clinicians, the women of Cork and the staff who work in the South Infirmary-Victoria University Hospital.

If we are genuinely serious about women's health, the reduction of cancer and early detection, this would be a flawed move. The South Infirmary-Victoria University Hospital is by far the best, the largest and the most specialised unit in the south, with a proven track record that is second to none. Its statistics in diagnosis and the way it treats people have been well documented. If we are talking about creating better efficiencies and value for money, I cannot understand why we invested millions of euro and then suddenly decided to move from campus A to campus B in Cork University Hospital. It does not make sense. It is a waste of money, is a vote of no confidence in the staff of South Infirmary-Victoria University Hospital and does not instill confidence in the women of Cork. I have reams of e-mails and copious volumes of notes from public meetings where woman after woman has raised these issues.

If the Government wants greater networking and two hospital campuses, that is fine, but let us keep services at the existing campus where BreastCheck was invested in by the Government. Why move to the already packed and straining campus of Cork University Hospital? It does not make sense. If we are talking about the whole issue of HSE accountability, Professor Drumm and his merry men and women are saying one thing but, on the ground, the staff working in the HSE, of all grades, are diametrically opposed to their view and have no confidence whatsoever in the operation of the HSE. I challenge any staff member of the Department of Health and Children or the HSE, or the Minister of State, Deputy Moloney, and the Minister, Deputy Harney, to tour the front-line services of hospitals throughout the country. Morale is low and confidence is critically low. Yet, we are today subsuming five agencies into the HSE and the Department. While I accept we must create efficiencies and achieve value for money, at what cost and risk?

Senator de Búrca gave an eloquent speech about the Crisis Pregnancy Agency and I would like to be associated with Senator Corrigan's remarks concerning Cura. I hope Cura will continue to be funded because the reduction or elimination of abortion should be on all of our political agendas. While I do not have access to figures on the issues raised by Senator de Búrca, I suggest we need to visit the schools and give detailed consideration to how best we educate young people. I would go a step further and move beyond the schools to the youth cafes and youth clubs. We have an obligation to educate our young people, irrespective of their sexuality, as Senator Norris said, with a view to eliminating abortion and looking after our young people.

I thank the Minister of State and his officials for attending and for their patience. I appeal to the Minister of State at this eleventh hour to go back to the Minister, Deputy Harney, and the HSE with regard to the national cancer strategy and the proposed transfer of services at South Infirmary-Victoria University Hospital to Cork University Hospital.