I move: "That the Bill be now read a Second Time."
Since the last election the Progressive Democrats have taken the rare opportunities presented to us in Private Members' time to debate and promote issues of real importance for this country. In particular, we have introduced three important Bills, one on ministerial pensions which sought to end what remains a scandalous abuse, another, the Local Government (Planning and Development) Bill which tried to end the payment of compensation to land speculators where they were refused planning permission and deal with the problem of unfinished housing estates, and our most recent Bill on competition policy which sought to radically reform the economy into one which favoured, encouraged and controlled competition.
Tonight we are introducing another vital Bill. The Health Ombudsman Bill, 1989, deals with the whole area of health policy here and seeks in particular to create the office of health ombudsman responsible to the Oireachatas and having a supervisory role in relation to the provision of hospital services to the public. The establishment of this office is essential if we are to ensure that ordinary people have their entitlements to immediate health care protected.
Like the majority of Deputies in this House I have been inundated over recent months with requests from members of the public and the families of sick people to try to get patients into hospital. By the Government's own account there are over 22,000 people on waiting lists for hospitals. Many of these people have been waiting for over 18 months and are still no nearer a hospital bed. People are getting desperate and are contacting anyone they feel can help them. Who one knows and what pull one has is becoming more important than what is wrong with a person.
This is just one symptom of a very sick health service but a very worrying one. Throughout the country there are examples of abuse of power, whether with the allocation of national lottery funds or the granting of planning permissions. The common thread is that if one is in with the "in crowd" one will be looked after. This attitude is deplorable in any walk of life but when it enters the medical arena it is intolerable. This Bill seeks to tackle it.
The Bill aims to provide for the creation of a health ombudsman to investigate the provision of medical and surgical services in public hospitals. We have deliberately modelled the Bill on the Ombudsman Act of 1980 but there are a number of important differences. First, the sole function of the health ombudsman is to investigate complaints by or on behalf of persons with either full or partial eligibility under the Health Acts or who have policies of insurance with the VHI or who are the holders of health insurance licences in relation to the provision of administration by a public hospital or health board.
Second, the complaints must, in the main, demonstrate the procedures adopted by the health board are unfair or discriminatory or based on an improper method of devising a scheme of priority for the treatment of patients, or amount to a misdirection or waste of public moneys or are otherwise contrary to sound principles in hospital administration.
Third, the health ombudsman is empowered to give mandatory directions to the hospital or health board concerned. These directions may be appealed to the Minister for Health on the sole ground that the hospital or health board does not have adequate resources to comply with such a direction. We have allowed for appeals on this ground. If he does, however, he must present a statement of his reasons in writing for doing so before each House of the Oireachtas.
The objective of this Bill, therefore, is to provide some independent arbitrator for patients using public hospitals and to provide a check against improper or wasteful decisions of the hospital or health board bureaucracies. While the Bill has no financial implications in that hospitals or health boards may appeal against directions of the health ombudsman which they cannot meet out of their own resources, it will serve to highlight any deficiencies and undue waiting lists for the range of medical and surgical services available.
Section 1 provides for the establishment of the office of the health ombudsman and for his terms of office. Section 2 provides that he shall be independent in the performance of his duties.
Section 3 (1) provides that the health ombudsman may investigate complaints which he considers warrant investigation. Subsection (2) of this section specifies the grounds of complaint which might justify a preliminary investigation on the part of the health ombudsman.
Section 3 (3) provides that the complaint must be by or on behalf of a person with full or limited eligibility or with a VHI insurance policy and the complaint must relate to the provision and administration of medical and surgical services by a public hospital or health board. Sections 3 (4) and (5) are modelled on equivalent provisions of the Ombudsman Act, 1980.
Section 4 provides for a resolution of complaints procedure. Section 4 (1) allows the health ombudsman to give mandatory directions to health boards and hospitals in relation to the provision of surgical and medical services.
Section 3 (4) allows for an appeal to the Minister for Health on the sole ground of insufficiency of means or resources to comply with such a direction.
Section 4 (6) provides that if an appeal is allowed, the Minister must cause a statement of reasons in writing to be laid before the Oireachtas.
Section 5 is an interpretation section and the definition of hospital ensures that only public hospitals, in the sense of nonprofit making hospitals, are included within the remit of the Bill and, finally, section 6 provides for a short title and the commencement day.
Important as it is, I am under no illusion that this Bill will solve the problems of our health services. The fact is that these services are now in crisis. Two years after crawling to power on the backs of promises about "A better way" and a reformed health service, this Government have totally reneged on these health services. The Irish health services have been destroyed over the past two years by this Fianna Fáil Government. Although one of their main promises on the hoardings that were all around this country during the last election campaign told us that health cuts hurt the old, the sick and the handicapped, it is ironic that since this Government came to office their only policy in relation to our health services has been one of cutbacks, cutbacks and more cutbacks. Three thousand acute hospital beds have been closed since Deputy O'Hanlon assumed office, with the result that there are now an estimated 22,380 people waiting to get into hospital for essential treatment. Many medics have told me that some of their patients will die before they can get into hospital for much needed treatment. In Dublin it is now virtually impossible to get into hospital unless one is certified as an emergency. Family doctors are advising their patients to call an ambulance as that is the only way they can hope to be admitted to hospital. The city hospitals are now almost totally taken over by patients admitted to the accident and emergency services.
One of the country's largest hospitals, St. James's in Dublin, reached the stage recently where patients requiring surgical and diagnostic procedures on a one day basis were sent home because all the beds allocated to those services were taken up by emergency cases admitted the previous night when the hospital was on call. Professor David McConnell, chairman of the board of the Adelaide Hospital, said that the public patient is being deprived of proper hospital care by the State, that waiting lists run up to 18 months for some people and that doctors know that usually they cannot admit patients unless they are seriously ill and that the postponement of elective care prolongs pain and discomfort, and sometimes dangerously exacerbates the underlying problem. The private patient, according to Dr. McConnell, can sometimes arrange for prompt treatment but the public patient must always wait.
We are aware of the dreadful situation which arose recently in the Southern Health Board when money was so short that staff were told the board would have to defer payment of their salaries. In the face of political and trade union fury, the Minister ran for cover and the money was provided to meet the pay cheques, while officials of the impoverished Department of Health flew to Cork to arrange for the demotion of the board's acting chief executive officer. No solution has been found even yet for the Southern Health Board's problems.
Proposals to slash the number of beds at Tralee General Hospital at weekends were attacked earlier this month by Dr. Dick Shanahan, president of the Irish College of General Practitioners, as being dangerous and unworkable. He said that if they were implemented GPs could be left in the very frightening position of having patients with an acute illness on their hands and no hospital beds available to take them.
Up to recently I thought this dire shortage of acute hospital beds existed throughout the country, but I was wrong. It does not exist in at least one hospital. A report by the North-Eastern Health Board has revealed that in Monaghan County Hospital the number of beds is in excess by 65 of what is required to serve the area. It may be a coincidence that Monaghan County Hospital is in the Minister's constituency. However, other areas of the country and other people have not been so fortunate.
The national open heart surgery centre in the Mater Hospital in Dublin will only be allowed to carry out 700 operations this year because of a shortage of money. There are between 300 and 400 people on a waiting list and the number is growing daily. People have to wait months to get into the Mater for vital open heart surgery. Recently a cardiologist told me that he does not inform a patient of the need for surgery until he knows he can get the person a bed, because of the danger to health of having to wait many months before getting into hospital for surgery. This is an appalling situation that no Government should tolerate, and it is one I am sure the people will give a clear opinion on, whenever they are given the chance.