Feargal Quinn (Independent)

I agree with Senator Feeney. It is a joy to listen to the Minister who has no notes but is able to provide us with statistics during her contribution. The other reason it is a joy is because she brought us good news. I was not aware of the increase in life expectancy and of the improvements in patient safety, and in outcomes for breast cancer and prostate cancer. From those perspectives it is a delight to hear what the Minister had to say.

I am also pleased to hear about the efforts in regard to care in the home. I have been a big advocate of moving to care alternatives, including day care, primary care and community care. Hospital care should really be supplemented by alternatives. I am not sure we have done that to any great extent in the past. I read on Monday about this sort of initiative being introduced in several hospitals in Canada. They are calling it "culture change" and they hope it will result in so-called alternative level of care patients; that is, patients occupying a bed who no longer require the intensity of resources and services a hospital provides. Such patients are being moved more efficiently from the hospital to appropriate care settings in the community. This approach has not been properly examined in this country. We need to convince the public that the obvious savings made in hospitals will be to the benefit of the community and to long-stay care.

The Minister informed us that much progress has been made in the HSE in setting cancer care standards but, unfortunately, that fact does not make the headlines. There is still a lack of uniformity in the HSE organisation in many areas. For example, the child care assessment and protection guideline standards still differ across the country. I understand uniform guidelines in the assessment of suspected miscarriage in early pregnancy are only being drawn up at the moment for maternity units. Perhaps the Minister will bring us up to date in that respect. Senator Fitzgerald has referred to the matter also.

One can ask how all the problems can be addressed. The incoming head of the HSE, Cathal Magee, faces a difficult challenge. The small bit of advice I will give to him is to listen to what the customer says. I always refer to patients as customers. I told the Minister previously that when I was chairman of a hospital I made an effort to change "patient" to "customer" but the doctors did not care for it and I did not get my way. I have always maintained that a good leader should be an excellent listener. Mr. Magee can acquire much information on how to do the right thing by listening. Perhaps every customer could fill in an on-line form after visiting a hospital and the HSE could act on that source of information which is so easy to obtain and is right under its eyes.

The Minister did not refer to organ donation today. Currently, more than 600 people are waiting for life-saving transplant operations. A total of 243 organ transplants took place in this country in 2009. A Bill was introduced in the House but debate on it was adjourned as the Minister wished to consider the area more closely to see what could be achieved. The Bill related to presumed consent. I understand that on its own presumed consent will not solve the problem but a great deal can be achieved with transplant co-ordinators in hospitals. I accept the Minister is inquiring into the matter to see what can be done. I am hopeful that something would happen soon because it is almost two years since the Bill was introduced. I was pleased to see that more than 96% of the European Parliament voted for a directive aimed at increasing the number of organs available for transplantation among member states throughout the European Union. It will also facilitate the exchange of organs and expand the pool of organs available. Much can be done.

The reason I introduced the Bill was because I knew a number of people who required organ donation. Three people were affected in one shop. One young man died although his mother went to great pains to try to organise an organ transplant for him, but two others are still alive because they managed to get transplants. People are dying because we have not found a solution to the problem. Presumed consent is the right way to go. I accept the Minister has some reservations and she is carrying out an investigation in order to get support for whatever steps she takes in the area. Matters are dragging on and each month we delay, people are dying. I urge the Minister to take steps, whether by way of presumed consent or a different form of consent, because people are being put into the grave with organs they would be quite happy to have used. If families are not happy they can opt out. We would save lives on that basis. I urge the Minister to do something about organ transplants as soon as possible.