John Crown (Independent) | Oireachtas source

I am sorry to interrupt the combined history lesson and party political broadcast we have seen this morning. I will make a happy announcement to the House. In San Francisco two days ago, Dr. Pierre Thirion, acting on behalf of the Ireland Co-operative Clinical Oncology Research Group, presented a paper selected for the very top presentation at the American Society for Radiation Oncology, ASTRO, conference. It is the leading meeting in the world for radiation therapy of cancer and thousands of papers are submitted every year, with a few accepted for presentation and a handful being accepted for what is called the plenary presentation. It has been described as "the Oscars" of radiation oncology research. Dr. Thirion did a study conducted entirely in Ireland and it was led, designed and run here by Irish doctors. I pay tribute to them for this extraordinary achievement in putting cancer research in this country on such an important stage.

The principle which underlies socialised health care is the notion that people will be looked after from the cradle to the grave, with appropriate access to health care based on need and not ability to pay throughout the long trajectory of a normal life. Sadly, over the past week, we have seen evidence that we are getting it systematically wrong at the extremes of life. I do not wish to personalise the issue to a particular hospital, as the fault is not with a hospital but rather the system in general. However, patients in Galway hospital receiving terminal care at the very end of their lives were forced to receive this in circumstances that were less than private and dignified. No fault can really be attached to any of the nurses or doctors involved but it underlines a gross underprovision of required services. That is not specific to this Government or the current or previous Minister but it is instead related to a creaking system in need of reform. It has required such reform for the 21 years I have been in the country, when it has been obvious that we needed to carry it out.

There is a similar issue at the beginning of life. During the week we heard reports of some sequelae of both the obstetric tragedy which occurred in Galway several years ago and also of problems in another hospital. I cannot make the point strongly enough that we have a grotesquely small number of specialists in obstetrics per head of population and we are way off the bottom of the European charts, despite having one of the highest birth rates in Europe. This cannot continue. All of the committees, bodies like HIQA, care pathways, guidelines and disciplinary hearings which occur afterwards will not fix this problem.

All of the disciplinary hearings that occur afterwards will not fix the problem; it must be fixed prospectively. It is not just a question of plugging in an extra couple of hands here or there; it is a question of reforming the system. I feel that I have been defrauded because I backed the Government parties when they were in opposition and came forward with plans to reform the health system based on insurance, which was one of the five key points of their reform policy. I want the Government to tell us its plan for implementing it because all of the mood music we have been getting both from the previous Minister, who said it would be implemented in a subsequent period of government, and from the current Minister, who is now effectively saying that the advice of his officials is that it may never be implementable, is very confusing.

I urge that we get clarity on this issue and I believe that we need a specific debate in this House - not a broad ramble about the health service, but one in which the Minister comes in to us to tell us exactly what happened to the plan; what were the criteria that were not met that made Fine Gael decide it was no longer implementable; what it will do in future; and if it is not to proceed, what is its alternative vision for the health service.