Health Bill 2004: Motion to Recommit.

Thursday, 9 December 2004

Dáil Eireann Debate
Vol. 595 No. 1

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Ms McManus: Information on Liz McManus  Zoom on Liz McManus  I move:

I wish to explain why I move this motion. I regret that the Minister for Health and Children is not present but I think it is an indication of the problematic way in which this Bill has been dealt with. A major transformation of the health service is envisaged under the terms of this Bill, which will change radically the relationship between members of the public and the health service upon which they depend. The legislation is being rushed through the House at a disgraceful speed, without proper scrutiny, preparation or consultation. People with an interest in knowing what is going on with these changes have not had a chance to read the proposed changes.

On Committee Stage we had an enormous number of amendments proposing radical changes in the relationship between the Health Service Executive and the Department of Health and Children. In effect, the Health Service Executive, through its chief executive officer, who is the sole accounting officer, will be responsible for a budget comprising €8 billion of public moneys, and the figure is rising. That, in itself, is a serious change.

Some 140 amendments, spanning 72 pages, have been tabled for Report Stage. Some of them will not increase accountability, as the Minister promised, but will reduce it. We are not yet living in a dictatorship. I ask the Government to meet its obligations concerning public accountability and ensure that legislation is sound, which is [44]doubtful in this case because of the speed at which the Bill is being rushed through, and properly scrutinised, although that is clearly not the case.

Major changes are envisaged on Report Stage. The Government’s many amendments were furnished to Opposition spokespersons last night, but that is unacceptable. Nobody has the right to abuse the Oireachtas in this way. I realise that the Minister of State is caught in a bind because it is not his Bill. The Minister for Health and Children should be here to take the Bill. The reputations of both the Minister of State and the Minister are being seriously damaged by this headlong rush whereby the Bill must be passed, no matter what the cost to accountability and good, responsible legislation. As far as the Government is concerned, it does not seem to matter a damn. The Government just wants to drive the legislation through relentlessly, but that is not good enough. The Bill should be recommitted.

It took approximately two years for the Health Act 1970, which established the health boards, to pass from publication to implementation. With this Bill before us, which proposes to dismantle the health boards and goes much further in dismantling the normal accountability of a Department, it is taking a matter of days to pass through the Houses. We have no chief executive officer and do not have a health service executive either. There are serious industrial relations problems. The likelihood is that the lack of partnership and union co-operation will worsen because of what is being done here. I urge the Government to accept the motion for recommittal so that we can do our job properly and effectively.

Acting Chairman: Information on Seán Ardagh  Zoom on Seán Ardagh  Before I ask the Minister of State if he wishes to respond to the motion that the Bill be recommitted, I will ask Deputy Twomey to contribute.

Dr. Twomey: Information on Liam Twomey  Zoom on Liam Twomey  I support the motion. Deputy McManus and I submitted at least 90 amendments on Committee Stage. We allowed for that Stage to be moved along speedily and efficiently because we were promised there would be no guillotine on Report Stage, that our amendments would be taken on board and that we would clearly understand where our amendments stood on Report Stage. We have only just received the book of amendments for Report Stage but, unfortunately, some of the Minister’s amendments are not included. Time constraints have prevented us from speaking to the voluntary sector, patients’ representatives and health service employees, including unions and professional bodies, all of whom will be affected by the legislation. We have had no opportunity to consult those concerned.

Reading through the amendments as presented this morning, I found it difficult enough to find where my amendments have been placed. I have no idea whether the Minister has genuinely taken on board what was said on Committee Stage. It is not crystal clear. An example of this lack of [45]clarity can be found in regard to the effect of this legislation on the ability of Members of this House to make representations. Amendment No. 79 makes some reference to Members getting answers from the HSE. The provision is not clear, however. A significant number of amendments were put through on Committee Stage which asked for information to be made available to the Oireachtas Committee on Health and Children and to Deputies by the Minister, the chief executive officer and board of the HSE, advisers, local authorities and other statutory agencies. It is impossible to discover whether our amendments have been taken on board.

We are expected to go through this legislation in less than three hours. The enactment of the Bill will entirely change the manner in which the health service is run. It will assign power to 11 people to manage €11 billion of taxpayers’ money in the context of a lack of clarity regarding the procedures for accountability. I am sure the Tánaiste will say that some of our concerns have been taken on board. However, it is interesting to read some of her amendments. For example, the amendment relating to the provision of information to the Oireachtas Committee on Health and Children uses the word “or” rather than “and-or”. This means that either the Minister or the committee will get the information. Presumably, committees will receive such information if they request it.

There is a distinct lack of transparency and accountability throughout the legislation. I am afraid the Bill does not look after the concerns of patients and health service employees. In years to come, there will be no accountability in the health service. I strongly support the motion to recommit the Bill.

Mr. Gormley: Information on John Gormley  Zoom on John Gormley  I support the previous two speakers. I regret that the Tánaiste cannot be here to listen to Members’ contributions. She told us on Committee Stage that she was listening attentively and would take on board our concerns. The most significant of these concerns is that the legislation is being rushed through the House with unseemly haste. It is unacceptable to process legislation in this way.

It became clearer with every minute we spoke on Committee Stage that this legislation had not been properly thought out. The concept sounded fine in theory. When we got down to the detail, however, the problems were obvious. For example, the basic difference between the role of the chief executive officer of the HSE and that of the corresponding interim position had not been teased out. Many unforeseen hurdles arose and it was left to the Tánaiste to amend the legislation.

[46]The Tánaiste has described the Bill as historic and this is true in the context of health legislation. It represents the most significant overhaul of the health services since the Health Act 1970. Clearly, legislation of such importance should be afforded much time and thought in an effort to tease out every eventuality. The Tánaiste is aware of the concern I expressed on Committee Stage that the most important area of accountability has been bypassed. The Tánaiste claimed to share this concern but I do not see that reflected properly in the amendments.

We cannot proceed in this fashion. The Bill has been rushed through and guillotined. The guillotine has been used on many occasions by this Administration to the detriment of legislation and in a manner that undermines the House. This Bill serves to move power away from the Dáil and give it to unelected persons. This is fundamentally wrong and is the reason I am opposed to the legislation and, in particular, the manner in which it is being processed.

Minister of State at the Department of Health and Children (Mr. B. Lenihan): Information on Brian Joseph Lenihan  Zoom on Brian Joseph Lenihan  The House ordered its business this morning for today and the motion now proposed is to recommit the Bill to Committee Stage. It is interesting that many of the contributions on this issue have canvassed the merits or otherwise of the proposal itself and were more appropriate to a Second Stage debate. For example, Deputy Gormley spoke about the nature of the structure that will be established under this legislation.

The Government decided to bring forward the proposals contained in this legislation in July 2003.

Ms McManus: Information on Liz McManus  Zoom on Liz McManus  Why then are there so many Government amendments on Report Stage?

Mr. B. Lenihan: Information on Brian Joseph Lenihan  Zoom on Brian Joseph Lenihan  Those proposals were on foot of the detailed recommendations in the Prospectus report, published earlier that year. The merits and demerits of what we are about have been canvassed and debated at length in the relevant public fora.

Ms Lynch: Information on Kathleen Lynch  Zoom on Kathleen Lynch  Why then have so many faults been found with the legislation?

Mr. B. Lenihan: Information on Brian Joseph Lenihan  Zoom on Brian Joseph Lenihan  We are now dealing with the detailed legislative implementation of the decision that was taken in principle. I do not wish to return to a debate on the principle of the Bill. However, I will not let the suggestion pass that the new system is unaccountable. On the contrary, the accountability which now rests with the health boards will be transferred to the Minister and this House.

Question put.

[45][47]The Dáil divided: Tá, 47; Níl, 61.

Information on Bernard Allen  Zoom on Bernard Allen  Allen, Bernard. Information on Dan Boyle  Zoom on Dan Boyle  Boyle, Dan.
Information on James Breen  Zoom on James Breen  Breen, James. Information on Thomas P. Broughan  Zoom on Thomas P. Broughan  Broughan, Thomas P.
Information on Richard Bruton  Zoom on Richard Bruton  Bruton, Richard. Information on Joan Burton  Zoom on Joan Burton  Burton, Joan.
Information on Ciaran Cuffe  Zoom on Ciaran Cuffe  Cuffe, Ciarán. Information on John Deasy  Zoom on John Deasy  Deasy, John.
Information on Jimmy Deenihan  Zoom on Jimmy Deenihan  Deenihan, Jimmy. Information on Bernard Durkan  Zoom on Bernard Durkan  Durkan, Bernard J.
Information on Damien English  Zoom on Damien English  English, Damien. Information on Martin Ferris  Zoom on Martin Ferris  Ferris, Martin.
Information on Eamon Gilmore  Zoom on Eamon Gilmore  Gilmore, Eamon. Information on John Gormley  Zoom on John Gormley  Gormley, John.
Information on Tom Hayes  Zoom on Tom Hayes  Hayes, Tom. Information on Seamus Healy  Zoom on Seamus Healy  Healy, Seamus.
Information on Paul Kehoe  Zoom on Paul Kehoe  Kehoe, Paul. Information on Kathleen Lynch  Zoom on Kathleen Lynch  Lynch, Kathleen.
Information on Pádraic McCormack  Zoom on Pádraic McCormack  McCormack, Padraic. Information on Dinny McGinley  Zoom on Dinny McGinley  McGinley, Dinny.
Information on Finian McGrath  Zoom on Finian McGrath  McGrath, Finian. Information on Paul McGrath  Zoom on Paul McGrath  McGrath, Paul.
Information on Paddy McHugh  Zoom on Paddy McHugh  McHugh, Paddy. Information on Liz McManus  Zoom on Liz McManus  McManus, Liz.
Information on Olivia Mitchell  Zoom on Olivia Mitchell  Mitchell, Olivia. Information on Arthur Morgan  Zoom on Arthur Morgan  Morgan, Arthur.
Information on Breeda Moynihan-Cronin  Zoom on Breeda Moynihan-Cronin  Moynihan-Cronin, Breeda. Information on Gerard Murphy  Zoom on Gerard Murphy  Murphy, Gerard.
Information on Caoimhghín Ó Caoláin  Zoom on Caoimhghín Ó Caoláin  Ó Caoláin, Caoimhghín. Information on Aengus O Snodaigh  Zoom on Aengus O Snodaigh  Ó Snodaigh, Aengus.
Information on Fergus O'Dowd  Zoom on Fergus O'Dowd  O’Dowd, Fergus. Information on Brian O'Shea  Zoom on Brian O'Shea  O’Shea, Brian.
Information on Jan O'Sullivan  Zoom on Jan O'Sullivan  O’Sullivan, Jan. Information on Séamus Pattison  Zoom on Séamus Pattison  Pattison, Seamus.
Information on Ruairí Quinn  Zoom on Ruairí Quinn  Quinn, Ruairí. Information on Pat Rabbitte  Zoom on Pat Rabbitte  Rabbitte, Pat.
Information on Michael Ring  Zoom on Michael Ring  Ring, Michael. Information on Eamon Ryan  Zoom on Eamon Ryan  Ryan, Eamon.
Information on Seán Ryan  Zoom on Seán Ryan  Ryan, Seán. Information on Trevor Sargent  Zoom on Trevor Sargent  Sargent, Trevor.
Information on Joe Sherlock  Zoom on Joe Sherlock  Sherlock, Joe. Information on Róisín Shortall  Zoom on Róisín Shortall  Shortall, Róisín.
Information on Emmet Stagg  Zoom on Emmet Stagg  Stagg, Emmet. Information on David Stanton  Zoom on David Stanton  Stanton, David.
Information on Liam Twomey  Zoom on Liam Twomey  Twomey, Liam. Information on Mary Upton  Zoom on Mary Upton  Upton, Mary.
Information on Jack Wall  Zoom on Jack Wall  Wall, Jack.  

Information on Dermot Ahern  Zoom on Dermot Ahern  Ahern, Dermot. Information on Noel Ahern  Zoom on Noel Ahern  Ahern, Noel.
Information on Barry Andrews  Zoom on Barry Andrews  Andrews, Barry. Information on Seán Ardagh  Zoom on Seán Ardagh  Ardagh, Seán.
Information on Niall Blaney  Zoom on Niall Blaney  Blaney, Niall. Information on Johnny Brady  Zoom on Johnny Brady  Brady, Johnny.
Information on Martin Brady  Zoom on Martin Brady  Brady, Martin. Information on John Browne  Zoom on John Browne  Browne, John.
Information on Joe Callanan  Zoom on Joe Callanan  Callanan, Joe. Information on John Carty  Zoom on John Carty  Carty, John.
Information on Donie Cassidy  Zoom on Donie Cassidy  Cassidy, Donie. Information on Michael Collins  Zoom on Michael Collins  Collins, Michael.
Information on Brian Cowen  Zoom on Brian Cowen  Cowen, Brian. Information on John Cregan  Zoom on John Cregan  Cregan, John.
Information on Martin Cullen  Zoom on Martin Cullen  Cullen, Martin. Information on John Curran  Zoom on John Curran  Curran, John.
Information on Síle de Valera  Zoom on Síle de Valera  de Valera, Síle. Information on Tony Dempsey  Zoom on Tony Dempsey  Dempsey, Tony.
Information on John Dennehy  Zoom on John Dennehy  Dennehy, John. Information on Jimmy Devins  Zoom on Jimmy Devins  Devins, Jimmy.
Information on John Ellis  Zoom on John Ellis  Ellis, John. Information on Michael Finneran  Zoom on Michael Finneran  Finneran, Michael.
Information on Dermot Fitzpatrick  Zoom on Dermot Fitzpatrick  Fitzpatrick, Dermot. Information on Jim Glennon  Zoom on Jim Glennon  Glennon, Jim.
Information on Noel Grealish  Zoom on Noel Grealish  Grealish, Noel. Information on Mary Harney  Zoom on Mary Harney  Harney, Mary.
Information on Seán Haughey  Zoom on Seán Haughey  Haughey, Seán. Information on Máire Hoctor  Zoom on Máire Hoctor  Hoctor, Máire.
Information on Joe Jacob  Zoom on Joe Jacob  Jacob, Joe. Information on Cecilia Keaveney  Zoom on Cecilia Keaveney  Keaveney, Cecilia.
Information on Billy Kelleher  Zoom on Billy Kelleher  Kelleher, Billy. Information on Peter Kelly  Zoom on Peter Kelly  Kelly, Peter.
Information on Tony Killeen  Zoom on Tony Killeen  Killeen, Tony. Information on Seamus Kirk  Zoom on Seamus Kirk  Kirk, Seamus.
Information on Tom Kitt  Zoom on Tom Kitt  Kitt, Tom. Information on Brian Joseph Lenihan  Zoom on Brian Joseph Lenihan  Lenihan, Brian.
Information on Tom McEllistrim  Zoom on Tom McEllistrim  McEllistrim, Thomas. Information on John McGuinness  Zoom on John McGuinness  McGuinness, John.
Information on John Moloney  Zoom on John Moloney  Moloney, John. Information on Donal Moynihan  Zoom on Donal Moynihan  Moynihan, Donal.
Information on Michael Moynihan  Zoom on Michael Moynihan  Moynihan, Michael. Information on Michael Mulcahy  Zoom on Michael Mulcahy  Mulcahy, Michael.
Information on Seán Ó Fearghaíl  Zoom on Seán Ó Fearghaíl  Ó Fearghaíl, Seán. Information on Charlie O'Connor  Zoom on Charlie O'Connor  O’Connor, Charlie.
Information on Willie O'Dea  Zoom on Willie O'Dea  O’Dea, Willie. Information on Liz O'Donnell  Zoom on Liz O'Donnell  O’Donnell, Liz.
Information on Dennis O'Donovan  Zoom on Dennis O'Donovan  O’Donovan, Denis. Information on Noel O'Flynn  Zoom on Noel O'Flynn  O’Flynn, Noel.
Information on Batt O'Keeffe  Zoom on Batt O'Keeffe  O’Keeffe, Batt. Information on Ned O'Keeffe  Zoom on Ned O'Keeffe  O’Keeffe, Ned.
Information on Fiona O'Malley  Zoom on Fiona O'Malley  O’Malley, Fiona. Information on Tim O'Malley  Zoom on Tim O'Malley  O’Malley, Tim.
Information on Peter Power  Zoom on Peter Power  Power, Peter. Information on Seán Power  Zoom on Seán Power  Power, Seán.
Information on Dick Roche  Zoom on Dick Roche  Roche, Dick. Information on Michael Smith  Zoom on Michael Smith  Smith, Michael.
Information on Dan Wallace  Zoom on Dan Wallace  Wallace, Dan. Information on Mary Wallace  Zoom on Mary Wallace  Wallace, Mary.
Information on Joe Walsh  Zoom on Joe Walsh  Walsh, Joe. Information on Ollie Wilkinson  Zoom on Ollie Wilkinson  Wilkinson, Ollie.
Information on Michael J. Woods  Zoom on Michael J. Woods  Woods, Michael.  

[47]Tellers: Tá, Deputies Stagg and Kehoe; Níl, Deputies Kitt and Kelleher.

[47]Question declared lost.

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