Thursday, 9 December 2004
Dáil Eireann Debate
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 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.
Dr. 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 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: 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.
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): 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.
Mr. B. 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.
Mr. B. 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.
|Allen, Bernard.||Boyle, Dan.|
|Breen, James.||Broughan, Thomas P.|
|Bruton, Richard.||Burton, Joan.|
|Cuffe, Ciarán.||Deasy, John.|
|Deenihan, Jimmy.||Durkan, Bernard J.|
|English, Damien.||Ferris, Martin.|
|Gilmore, Eamon.||Gormley, John.|
|Hayes, Tom.||Healy, Seamus.|
|Kehoe, Paul.||Lynch, Kathleen.|
|McCormack, Padraic.||McGinley, Dinny.|
|McGrath, Finian.||McGrath, Paul.|
|McHugh, Paddy.||McManus, Liz.|
|Mitchell, Olivia.||Morgan, Arthur.|
|Moynihan-Cronin, Breeda.||Murphy, Gerard.|
|Ó Caoláin, Caoimhghín.||Ó Snodaigh, Aengus.|
|O’Dowd, Fergus.||O’Shea, Brian.|
|O’Sullivan, Jan.||Pattison, Seamus.|
|Quinn, Ruairí.||Rabbitte, Pat.|
|Ring, Michael.||Ryan, Eamon.|
|Ryan, Seán.||Sargent, Trevor.|
|Sherlock, Joe.||Shortall, Róisín.|
|Stagg, Emmet.||Stanton, David.|
|Twomey, Liam.||Upton, Mary.|
|Ahern, Dermot.||Ahern, Noel.|
|Andrews, Barry.||Ardagh, Seán.|
|Blaney, Niall.||Brady, Johnny.|
|Brady, Martin.||Browne, John.|
|Callanan, Joe.||Carty, John.|
|Cassidy, Donie.||Collins, Michael.|
|Cowen, Brian.||Cregan, John.|
|Cullen, Martin.||Curran, John.|
|de Valera, Síle.||Dempsey, Tony.|
|Dennehy, John.||Devins, Jimmy.|
|Ellis, John.||Finneran, Michael.|
|Fitzpatrick, Dermot.||Glennon, Jim.|
|Grealish, Noel.||Harney, Mary.|
|Haughey, Seán.||Hoctor, Máire.|
|Jacob, Joe.||Keaveney, Cecilia.|
|Kelleher, Billy.||Kelly, Peter.|
|Killeen, Tony.||Kirk, Seamus.|
|Kitt, Tom.||Lenihan, Brian.|
|McEllistrim, Thomas.||McGuinness, John.|
|Moloney, John.||Moynihan, Donal.|
|Moynihan, Michael.||Mulcahy, Michael.|
|Ó Fearghaíl, Seán.||O’Connor, Charlie.|
|O’Dea, Willie.||O’Donnell, Liz.|
|O’Donovan, Denis.||O’Flynn, Noel.|
|O’Keeffe, Batt.||O’Keeffe, Ned.|
|O’Malley, Fiona.||O’Malley, Tim.|
|Power, Peter.||Power, Seán.|
|Roche, Dick.||Smith, Michael.|
|Wallace, Dan.||Wallace, Mary.|
|Walsh, Joe.||Wilkinson, Ollie.|
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