Last night I gave some figures regarding births at Bantry Hospital. Out of 823 births for the west Cork area, 191 were in Bantry Hospital and 533 were in Cork city. That is a clear indication of the position. It is unfortunate that this debate had to take place because irrespective of the issues involved some people see it as an opportunity to indulge in political points scoring. However, out of the whole unseemly argument perhaps there will be some good, because now that the matter is being discussed the facts will emerge clearly.
Since this controversy began and despite some efforts to cloud the issue it was clear to me that the only thing that mattered was to provide the best maternity services for the people of west Cork. That is what the debate is about. It is not about the retention of whatever services were provided in the hospital in the past or the ambitions of some people regarding future developments in the hospital. The issue was and continues to be that it is accepted that there is a minimum standard of maternity services that we are obliged to provide for all our people. To say that second best might do some people might be all right when one is attempting to score a political point, but we must be seen to provide the best service for everyone. We must not think that certain sections of the community should get only a second-class service.
The location of the services must be such that they will serve the needs of the community. These needs are well-known and were spelled out in detail in this debate by the Minister. They are to ensure the best care for mothers and babies. It is strongly recommended that deliveries take place in units staffed by consultant obstetrician-gynaecologists, with back-up paediatric services. The people in whose name this motion is tabled will agree that such services are not available in Bantry. There is an element of risk there.
If a post is advertised giving the number of births, the question must be asked, will the best consultant apply for the job? The ambitious, highly-trained consultant will want to work in the busy hospital, not necessarily for the sake of remuneration but because he wants to ensure that his expertise is kept up-to-date. That is something that must be taken into consideration when talking about appointments, particularly in small units. I do not think we would get the best person for the job for the reason I have given. I understand the arguments advanced by speakers on the other side. I do not say they are arguing merely for the sake of argument. However, we must consider the medical aspect and the welfare of the patient. We must ensure that the service we provide is the best.
A number of allegations and dubious suggestions were made, but the most cynical were made by the Leader of the Opposition and the spokesman on health. In the face of medical advice they gave commitments in relation to services in Bantry Hospital. It is unfortunate for the people in the area that this was done without regard to the advisability of the proposal or the ability to meet the commitments. It is easy to promise that one will keep a certain hospital open, but one must take account of the expert advice that is available. The people who made the commitment have a lot to answer for.
The commitments made by Fianna Fáil in relation to maternity services in Bantry Hospital are flying in the face of medical advice. Such advice should not be disregarded. There have been no counter-arguments from the opposite side of the House. All that has been pointed out are the circumstances of the west Cork community and the distance people have to travel unless a unit is provided in Bantry Hospital. I understand that argument, but it does not stand up when put to the test on medical grounds, and that is the only criterion that should be observed, namely, what is best from the medical point of view. I am aware of these factors — I am capable of reading maps and measuring distances — but in all honesty I do not believe that the upper solution, though it may be the easy one, is the provision of a second-rate unit in the Bantry Hospital.
I should like to hear arguments to the contrary, but until now nothing has been said that would alter the opinion that what we are doing is right and in the best interests of the mothers of west Cork. We have been putting forward the case that this sort of unit in Bantry could not be expected to cater for more than 300 births. My answer is that if we provide such a second-rate service we can have no doubt that the people concerned will go elsewhere. Figures indicate clearly that mothers in west Cork will not risk going to a hospital that lacks full maternity services.
Deputies opposite have been calling for what is nothing more than a botched-up job to keep the unit open. That is only a recipe for gross underutilisation of the proposed Bantry unit. We should never lose sight of our responsibility to serve the best interests of the people. We must ensure they will get the best.
Another factor to be taken into account is the economic one. I agree that finance considerations should not be allowed to be the overbearing influence, but the economics of this proposal must be looked at. We are not all living in fantasy-land, and I hope we all have come to the realisation that when we are spending taxpayers' money we will get for it the best value, the best service.
That is what our proposals will give. At the moment the health services are costing £1,000 million, or £290 per man, woman and child. This money does not come from some bottomless pit but from taxation of the working people. When we look at these figures we must ensure that we will provide good value for that money, in other words the best service that can be made available so that the people providing the money will get a return for it. Daily we hear people talking about the heavy burden of taxation. We all admit it is a heavy burden, and that makes the responsibility a heavy one to get value for money. The sooner the people of the House and the country appreciate this the sooner we will get out of our economic mess.
I have no hesitation in saying that the funding of an obstetrics unit in Bantry to cater for 300 births could not be justified on medical grounds. God forbid that anybody would try to justify it on political grounds, though people are trying to do that.
The Minister has made it clear here and outside that he will not be dissuaded from the decision he has taken. Rather than prolonging an obviously futile argument we should be concentrating on the provision of appropriate arrangements to provide a proper service for the parents of west Cork. When I say "proper" I mean the best service, that the people can have confidence in, a service that will give them the same consultant services they would have in the best out-patient hospital. If the people get that kind of service they will be happy, satisfied in the knowledge that those in large urban areas are getting the same standard of service. They will have back-up services, they will have child care at a time when the life of the baby needs the best service.
This is entirely a matter of informing the public. We have been making an over-riding case in favour of the mother and child. On reflection later I am sure we will ask why was all this heat generated in 1983 when now we are enjoying the best service that could be provided and that the people were entitled to.
