Paul Bradford (Fine Gael)

I want to say a few words on the legislation. Like many speakers, my comments might stretch slightly beyond the terms of the legislation and I respectfully seek the Acting Chairman's understanding for that in advance.

I listened with interest to my colleagues. Everybody in this House wants to see a situation brought about where we have a health system which delivers to the public. During my time in politics - this is a fair comment across the political spectrum - every person who has held the portfolio of Minister for Health, from Mr. Barry Desmond, Deputy Michael Noonan, Mr. Brian Cowen, Ms Mary Harney and the current incumbent, set out with fine ambition to deliver a health service of which he or she could be proud and which would serve the needs of the public. For various reasons, unfortunately, it has never worked to the extent that all of those Ministers would have wished. We have invested significantly in the health service. A considerable proportion of the national budget every year goes on the provision of health services but, sadly, the results are not as had been hoped for.

The previous speaker mentioned the Canadian health system. During my time - I do not want to get into fadó, fadó - we heard about Nirvana, which was the Australian system, and the Canadian system, the Dutch system and the Swedish system. There have been so many models of health service presented to us that one would almost have a picture of a calendar with all of these health models, month by month.

The Minister of State, Deputy Shortall, is presenting to us legislation which is brief in nature but, hopefully, rather more deep in substance, which will be one small step forward.

I understand that next week in this House there will be statements on the Department of Health's A Vision for Change document. Of course, there is a big jigsaw of policy areas in the health field which we need to tackle. However, from a layman's perspective, it always strikes me as a concern that we in this country do not appear to have enough people on the ground delivering the service. Notwithstanding the vast budget which is being spent on health, it is difficult to see any further resources being provided. Let us be honest about that, we do not seem to have enough practitioners. From doctors in surgeries to nurses in wards and consultants in hospitals, it seems there is an inadequacy in numbers.

Of course, we need this great debate on pay and the cost of all of these staff in the service and we need a debate on the training aspect. For instance, I recall two or three years ago here we discussed the new system of training, not for GPs but for entry into medicine. Clearly, there is a supply and demand problem. This legislation is about trying to respond to the lack of professionals but our aim must be to try to ensure we are able to train sufficient people in this country to provide for the health care needs of our people.

Obviously, we are now in a crisis situation with a capital "C", and urgent and immediate short-term remedies are required. That, I understand, is what the legislation is about. That it why it must be supported.

Obviously, I bow to the much superior knowledge on medical and related matters offered by persons such as Senator Crown. However, what people are asking us is what will be the position in a week's time, in a month's time and in six months' time. Hopefully, this legislation will be able to offer some degree of positives in that regard.

When the legislation is passed and when we all go home this week, the Minister of State and her colleagues in the Department of Health must give the most serious attention to looking beyond the short term and to at least the medium term, asking the substantial questions as to the numbers we train for medicine across the spectrum, how we pay for it and how we ensure we do not have this crisis in future.

It seems difficult to accept that in a county as modern in every respect as Ireland, in an advanced European Union, that from the perspective of a health service we are not delivering the first world service required. We are able to deliver first world education services, legal services and accountancy services, and yet we do not seem to be in a position, whether financially or in personnel terms, to deliver it in sufficient terms in the medical services.

The legislation is a necessary, small step forward. I look forward to next week's statements on A Vision for Change but also to the crucial next few months where, hopefully, the Minister of State, Deputy Shortall, and the Minister, Deputy Reilly, will come before us to present a broader vision of the future of the health system in this country, be it on the Dutch model or whatever. I hope thereby we can have a substantive debate on how we deliver to the people of this country the services that are not only expected but, in a modern economy, can be provided.