David Cullinane (Sinn Fein) | Oireachtas source

There is also the recruitment ban, restrictions on overtime and the hiring of agency staff, all of which are having a real impact on health services.

Senator Crown mentioned the deal with consultants. It may be a good deal but we will have to wait and see how it works. If there are fewer staff, fewer nurses, fewer doctors and less capacity in the surgical theatres, the deal will not amount to much. I come from the south east. This year, owing to cutbacks which the Government, the Minister for Health in particular, put in place, the regional hospital in the south east lost three of its surgical theatres, going from eight to five, 25 inpatient beds, six paediatric beds and front-line staff, all of which is having an impact on patient care. The Minister will have seen the reports of increased waiting times for outpatient activity and orthopaedic waiting times in Waterford Regional Hospital. He can shake his head but that is the reality. The clinical director at the hospital was on local radio this week confirming that is the case. In some areas waiting times have increased.

What we are trying to achieve is accountability in the health service. Pontius Pilate could not have arrived at a better system than the one in place. The major problem in the health service for far too long has been that no one takes responsibility, and that goes back to previous governments as well. How are we in a new era of responsibility when cuts of ¤130 million are announced, yet the Minister did not make those announcements, rather a senior civil servant? How is the buck stopping with the Minister and how is that taking responsibility for what is happening in the health service? It is not. The buck has to stop with the Minister and if there is to be accountability, he must take control. He made a big deal of saying he would take the reins of the Health Service Executive and he would take control, yet when the announcement of cuts of ¤130 million had to be made, he was nowhere to be seen. That is the reality. He was forced into a humiliating climbdown on the cuts to personal assistants for people with disabilities only because those unfortunate people camped outside Government Buildings to get the Minister to do what was right.

Mr. Cathal Magee resigned owing to problems in the health service and a lack of movement. There is no doubt the Bill provides for a slight improvement in services but it still creates a layer of bureaucracy. It is about management. Senator Crown is correct. What we want is a genuine health partnership.

What about the voice of patient groups? What about the voice of advocate groups? What about democratising the health service? That is something the Minister and his party spoke about when in opposition. They were critical of the previous Government, which abolished the health boards. What about local democracy and accountability? Why is it always bureaucrats and technocrats who are responsible for what is happening in the health service? What about people who represent real people such as people with disabilities? What about people who represent older people? What about local politicians who represent people who are elected? Surely they too should be part of how the health service is run.

The Minister's White Paper on universal health insurance is not going to be delivered as promised. It will be delayed, yet we still do not know how the scheme will be rolled out. I have heard a lot about the Boston, Berlin, Dutch and Deutsche models but I want one that is based on equality. We need a health model where a patient's treatment is based on need, and need alone, and not on their ability to pay. The system should be free at the point of delivery and funded through general taxation. That is what I want to see and it is the type of model that we should see.

The Government has shelved the scheme for free GP care to long-term illness patients. The measure has been placed on the backburner.

I wish to refer to an important issue raised by Mental Health Reform regarding the Bill. The organisation welcomes the Government's intention to improve the HSE's accountability through the Bill but it states: "[T]he current draft of the Bill does not ensure that a Director for Mental Health who has the competence to drive implementation of the Government?s mental health policy will be appointed." That important point needs to be taken on board.

I draw the Minister's attention to another important issue faced by patients and the people of the south east. I listened to the clinical director of Waterford Regional Hospital and I have listened to all of its consultants. They are concerned about a review of the hospital network in the region, the possible break-up of the clinical network in the south east and the potential for Waterford Regional Hospital to be networked with Cork. There is a fear that the region could lose services and that its regional hospital would be downgraded as a consequence. It is a real concern for the people in the region and I know that they have raised the matter with the Minister because they sent him their submission. They want to ensure that there are proper health services for people and that geography is not an issue when it comes to the type of treatment that one receives.

The Minister must do much better than this Bill if we are to deliver the type of public health service that the citizens of this country need. He must do better if we are to truly democratise the health service and ensure that patients and citizens get the treatment that they need as a right and is not based on their ability to pay or where they come from. The State has a responsibility to vindicate their right and deliver the best health services to the people of the State.