Marc MacSharry (Fianna Fail)

This is my first opportunity to welcome the Minister of State, Deputy Kathleen Lynch, to the House. I congratulate her on her appointment. If she has anything to do with reforming this issue, as Senator White and others have said, the future is certainly bright.

I am glad to have the opportunity to make certain points and I am conscious that others have greater expertise than I in the health area, including Senator Crown, and I look forward to hearing suggestions from one so knowledgeable of the health system. I can only speak as one with a business background and from personal experience, like other speakers, and I agree with much of what I have heard.

I will apply a pure business model to this case. Who projected a figure of €1 billion for the year and who is responsible when that €1 billion has run out after five months? Who is responsible for €100 million being misappropriated? Why is it taking so long for that review or examination to take place? When will we have the answers? If it was a commercial business, the answer would be instantaneous. If it was a business plan, it would be implemented the following day once it was decided. That is how these things are done.

I fundamentally disagree with the Health Act 2004 and spoke against it when I was on the other side of the House in regard to the abolition of the health boards. What was removed at that time was accountability. Now, when one writes to the HSE or to the Minister's office, although I am sure the current Minister will seek to change this, one receives a set-piece reply, "As you know, under the Health Act 2004, this is now an issue for the chief executive of the HSE and I have asked him to respond to you directly." That is what we get. At some stage down the line, when the response has been laundered through whatever public relations agency, that response may come back to the person asking the question.

This is the legacy of the centralisation of the health service through the HSE. It has slowed down and distorted the flow of information and it has not served the people well. I must qualify these comments by noting that there are many people working extremely hard and well in the HSE in caring for people in all of the various disciplines and in an administrative capacity. As a collective, however, it has not worked. The one thing I commend the new Government for doing is for acting to change it. I welcome the Minister, Deputy Reilly's initial intentions whereby he put an interim board in place but, that said, we have not seen much progress to date. What we have seen is that €100 million has gone missing, additional moneys have been made available for this scheme to continue in the short term and there is a huge question over who originally made the projections for €1 billion to cover a year when it has only covered five months. While there is now an additional €62 million to keep the scheme going for a period, what happens when that money runs out?

Notwithstanding the good suggestions regarding care of the elderly, the demographics are changing, we have an aging population and the challenges will be much greater in coming years than at present. I agree with organisations such as the housing associations in their assessments. To take the case of the NHS in Britain, studies across the west midlands, east midlands and the east of England generally demonstrate the cost savings made while increasing the quality of care and the contentment of patients. This is significant and, notwithstanding resource challenges, we must consider these kinds of initiatives.

The questions are clear. Who controls the money? One of the first things I would like the Government to do is to take the budget back under the Department of Health's control, so the Cabinet, which is the representative of the people and the Executive charged with running the State, has control. At present, €14.3 billion, or more than 50% of the tax take for this year, is in the control of a third party organisation which is still not in a position, several weeks on from 18 May when this issue broke, to tell us where that €100 million went. This is the people's money. Some €14.3 billion is better placed in the hands of the Cabinet of the day, which has direct accountability to the people and these Houses.

The challenges are immense. I know the Minister of State, Deputy Lynch, will take these questions on board. I know also that if she has anything to do with it, the future is bright on this issue. Nonetheless, the misappropriation of funds is of huge concern. As Senator Gilroy said, we probably need a weekly debate on some aspects of health in this House because there are so many important issues. I look forward to hearing those more qualified in health, such as Senator Crown and others, deliver their suggestions. From a pure business perspective, I am afraid that as a collective, notwithstanding the great work of the individuals, the HSE is a disaster.