Marie Moloney (Labour) | Oireachtas source

We are dealing with people's lives and the use of taxpayers' money. At the end of the day, the buck stops with the Minister. Those opposite will hold the Minister to account for whatever happens in the HSE; therefore, it should be accountable to the Minister. I do not know how this accountability was taken away from the Minister in the first place and what people were thinking when they did that but we are trying to improve the situation. What worries me gravely is what Senator Crown said that people who are in the system and who are trying to highlight the deficiencies and inefficiencies in it are being muzzled. That is not good enough. He was one of those who was strong enough to stand up and speak about it. What about all the others who tried to do so but who were shot down and whose jobs were threatened if they spoke out about the system?

I had reason to attend a consultant in the past year and we spoke about the health service. He told me he was the only consultant in the hospital - I will not name the man or the hospital because he would be identifiable - with one registrar under him. He told me he took the job in that hospital because he thought he could make a difference. He said he worked hard but that he had not been able to make a difference because the system was pulling him down. Anything which can ensure accountability is most welcome.

Earlier we debated the Ombudsman (Amendment) Bill 2008, the Ombudsman's office and accountability. This is all about accountability. We must be accountable. Today Senator Barrett introduced a new word "agencification" in the House. That is exactly what we have been getting - agency after agency. We need to pare this back, throw open the curtain and have accountability.

I have been led to believe there are between seven and eight layers of management between the front line services and the Minister. Why do we need all those layers of management? Nobody is arguing that we do not need management. Every agency needs to be managed properly but do we need so many managers answering to each other? I do not believe that is good enough and we could do away with many of those layers.

For several years replies to parliamentary questions submitted to the Minister or representations made to him have stated that it is a matter for the HSE. I do not expect the Minister to have all the answers at his fingertips because no Minister could possibly have them. However, if the Minister asks the HSE to report back to him, it should do so and we should get the answer eventually. For 12 months, I have been trying to get an answer from the HSE. I wrote to the Minister who forwarded my letter on to the HSE. God only knows where it went because I have been chasing it from pillar to post but cannot find it. I wrote to the Minister last November and it is nearly October but I still do not have an answer to that issue. It is not good enough. We should be able to get answers.

The HSE has operational responsibility but with this responsibility, there seems to be no accountability. With the abolition of the board of the HSE and the introduction of the directorate headed by the director general, I hope a speedy transition is forthcoming so that we can progress with our health reform programmes for the betterment of the public. One gets sick of political parties arguing about whose fault it is. We should forget about that and work with what we have and for the betterment of the people. We tried the HSE and the boards of the HSE and they did not work. Let us change the system. If it is not working, let us fix it.