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Dáil Éireann debate -
Wednesday, 2 Apr 2003

Vol. 564 No. 2

Leaders' Questions.

The Taoiseach will be aware from his staff, who read newspapers, watch television and listen to radio, of the horror stories that unfold every day in regard to health, horror stories involving people who are old, sick or have a disability – for instance, the 74 year old woman who spent 16 days as an in-patient on a trolley in Tallaght Hospital or the accident and emergency unit I visited recently where two suicidal psychiatric patients were under private security for two days.

Dublin hospital waiting lists are up 107% on the figure five years ago. We think the position is bad, but it gets worse every day. The latest insult is the disgraceful cutback in the number of hours available under the home help service scheme, which makes life bearable for many thousands of our citizens. In the North Eastern Health Board area alone there is a reduction of 85,000 home help hours this year. Is this not absolutely disgraceful and contemptible treatment of the vulnerable in our society who need that service? Is it right that in a country that has come through five of the strongest economic years we have ever enjoyed, people still wait four years for cataract or hip operations, seven years for orthodontic treatment and some years for cardiac treatment?

Is this not disgraceful treatment of the health services of our country? Is it not an indication of a complete lack of leadership and of the ability to manage professionally a service that has let people down? We have heard all about task forces and reports on health. We had the Brennan report, the Prospectus report and the task force on medical staffing. Will the Taoiseach tell the House how much has been spent on these reports and on consultants' queries over recent years? Has a single initiative from any of these reports made the lives of our patients or the health delivery service to them any whit better in recent years?

Deputies

Hear, hear.

The answer to the last question is "Yes". I could cite many areas, such as the cardiac and cancer areas, where we have seen enormous improvements overall. While funding in health is up by over 160% what is more important is that hospital activity is up almost one fifth. Waiting lists are down by about 14%. The number of people on waiting lists represented 3% of all discharges for acute hospitals last year. The number of people working in the consultancy service is up 26%. There have been enormous increases in resources in many of the health areas.

Of course there are pressures in hospitals. The Eastern Regional Health Authority is working closely with the hospitals mentioned by the Deputy, the five Dublin hospitals, St. Vincent's, the Mater, St. James's, Beaumont and Tallaght, on both the monitoring and evaluation of the activities, services and expenditure levels. There are problems, as the Deputy stated, which have been presented in recent days. The ERHA, with the individual hospitals and the Department of Health and Children, is looking at the service levels. There are hangover difficulties from last year where the service level component in the ERHA and the individual hospitals led to an overspend, which is being reduced this year, and this is creating some difficulties.

The ERHA has advised that the same total levels of services which it agreed with these hospitals last year would be provided for the hospitals this year. The authority has also said that additional money is available this year for cancer, cardiology and renal services. At a minimum there will be protection within the system for those services at the levels that were approved for last year. Provision is being made for the completion of major initiatives which commenced last year. There are an additional 300 acute beds at St. James's, St. Vincent's, St. Michael's, St. Joseph's Raheny and Naas. The Deputy asked about the position at Tallaght Hospital. The chief executive officer of the hospital met with the staff last Thursday. He is happy to meet them to resolve the industrial dispute in that particular hospital.

The Deputy asked about the North Eastern Health Board and the home help service. My information is that just three years ago the health board spent under €4 million on that service which represented about 10% of the budget for the elderly. This year some €8.2 million has been allocated to the home help service which represents 17% of the budget for the elderly. As can be seen from those figures there has been a dramatic increase. I do not know if I have answered all the questions the Deputy raised. He raised the issue of the Dublin hospitals, the services and reports.

In his last question he asked the cost of the reports. I do not have that figure but they are all being dealt with in trying to reform the system. We are spending €9 billion on the health service and some 96,000 people are working in it. It is the belief of most of people in the health service that we should look at structural reform of that area and that is what the Minister is engaged in.

This is the usual diatribe that is trotted out in response to every question. The single greatest failure of the Government in respect of health is that the bureaucracies are still as strong as ever and the services are not being delivered to the people. Last week, Deputy Olivia Mitchell asked the Minister for Health and Children to outline the budget for the 39 acute hospitals for 2003. The Minister responded by saying that level of detail was not available to him. Is there anybody in a major organisation, running major units, who does not know what is the available budget? Apparently the Minister for Health and Children is not told. How is it that the bill for taxis in the Louth-Meath area for acute hospitals for 2002 is €254,000? How is it that hours are being cut back? Is it because of the minimum wage paid to those who provide an essential home help service? The Taoiseach's response is typical of that from an accountant, it is an economic statistical response to a human problem. Give that answer to those who are lying on hospital trolleys today and to those who are lying at home in pain or in sickness waiting to be put on a list. In-patient and out-patient lists and figures are being combined and massaged. It is disgraceful that the Government is spending €9 billion of the people's money; it is like pouring it into a black hole as no effective service is being delivered. The bureaucracy is as strong as ever. Of the 24,000 employed in the health service, only 6,000 are nurses and doctors. That is an indictment and a failure of professional management and leadership of the health service.

Deputies

Hear, hear.

Deputy Kenny will describe whatever I say as a diatribe.

He is right.

In one breath he says that all these reports are a waste of money and that we should not carry them out and in the next he says the problem lies in the administration of these areas and that we should do something about it. Unfortunately, Deputy Kenny cannot have it both ways.

No decisions are taken.

Deputy Kenny either wants reform or he does not.

A Deputy

Could we have a little less conversation and more action?

Whether Deputy Kenny likes it or not, the Government in 2003 is investing €9.2 billion in the health service, an increase of €970 million on last year's figure. It is an enormous amount and represents an increase of 162% in the past five or six years. The Deputy has asked the individual areas where the increased sums will be spent.

It is like pouring water into a leaking bucket.

Deputy Allen is not the leader of his party.

We are spending €116.7 million on acute hospitals.

It will not go away.

In the area of disabilities, autism, mental health and palliative care, we are spending an additional €41 million. On older people we are spending €15 million. In respect of child care we are spending an additional €7.7 million and we are spending money on primary care. These are not just figures. They represent additional money for additional staff for additional facilities for additional treatment in additional hospitals. That is the reality.

For additional problems.

Has the Taoiseach's attention been drawn to the statement by the former US Secretary of State, Mr. James Baker, that "this is a war of choice, not a war of necessity"? Does the Taoiseach accept that public opinion regards this war as illegitimate, contrary to UN sanction, contrary to international law and driven by ideology, an ideology that threatens great instability in the region? I am sure he has seen the images of civilian casualties, which all of us have seen, the images of dismembered children and is aware of images which, according to today's "Morning Ireland" programme, are being reported from Baghdad as being too awful to be ever broadcast to the public. Against this background, does the Taoiseach still consider it appropriate to facilitate the war effort through Shannon? Does he think it is still appropriate for the Irish Government not to have a position on the new ideology or new doctrine of pre-emptive wars? Specifically, has he considered, as the leader of a neutral country, whether he ought to take some initiative with like-minded countries at the United Nations? In particular, has the Government given any consideration to invoking Resolution 377, the uniting for peace mechanism as it is known, to cause the United Nations that has been reduced to a bystander or a casualty of this conflict, to convene the General Assembly to address the grave issues we see on television every night?

Deputy Rabbitte has asked a number of questions. I share his concern and the views of everybody on the reality of what we see every night on our televisions. The realities and the horrors of war, particularly modern war, high technology and sophisticated weaponry, as always in wars, hit at the innocent people who have nothing to do with it, the women who were killed in the bus, the children who were killed in the market place. Our position for many months, as Deputy Rabbitte is aware, has been that we wanted to see this conflict resolved peacefully. We wanted to see it resolved in the context of the United Nations by the enforcement of Resolution 1441 and all the preceding resolutions. Unfortunately, that was not possible. The compliance necessary to ensure that happened in an effective way was not complied with by the Iraqi Administration. They had the opportunity to do that, and it would have helped had they done so but they did not. Unfortunately, we are now into a war position.

Deputy Rabbitte knows the legal position on this war. Internationally, it is only for the UN or the international organisations to declare whether this war is legal or illegal. There has been a difference of opinion on the definition within the UN on this matter for many months. The view of the United States and others is that they have authority under earlier resolutions. The view of Ireland and other countries was that it would have been preferable as a political imperative to come back with another resolution, whether it was a legal certainty or not. The legal position has not been clarified.

As regard pre-emptive strikes, we do not believe the question of pre-emptive strikes applies to this conflict. The reason for that is that the permanent representatives of both the US, the UK and Australia wrote separately to the President of the Security Council informing him that military action had been taken against Iraq. All three said the reason was Iraq's failure to disarm, so they had complied with the rules. The United Nations Charter allows for the use of force in two circumstances, first, when states are acting individually or collectively or in self defence or, second, when the Security Council has decided that force is necessary. In our view a second resolution would have been the way to resolve all of these difficulties but that did not happen. Internationally and legally, it is not considered to be a pre-emptive strike.

That is not true.

Deputy Rabbitte has asked me if it is the Government's intention to change its position on overflights and landings at Shannon. It is not the Government's intention to change its position. On humanitarian issues, I agree with Deputy Rabbitte, and initiatives we can take are being considered. The Minister will have important meetings tomorrow in Brussels, I think – the question of the venue had not been resolved early this morning when I last spoke to the Minister – to see what will happen. It was also suggested by some of the non-governmental organisations that I might speak to Kofi Annan and we are following that up. Anything we can do to assist the UN in the humanitarian effort will be done.

I am surprised the Taoiseach is trying to avoid the question of where we stand on the doctrine of pre-emptive war by denying it is happening. The leaders of the American Administration have made no secret of the fact that this is precisely what is happening and that this is the shape of world and geopolitics after 11 September. No one is denying the monstrous nature of this regime, but we have seen the horrific civilian casualties in this war, which we were told was about the possession of weapons of mass destruction, even though none so far has been found. We were then told the war was about regime change and then we were told it was about the liberation of people who would garland the troops with flowers as they went in. None of these things has happened. Is the Taoiseach satisfied that the United States is publicising the names of those who will be sent in on behalf of the American Government to manage the reconstruction of and run Iraq post war? Is the Taoiseach saying he is not prepared to consider the use of procedure 377 to cause the General Assembly to meet and, at a minimum, try to limit the war and ensure that the reconstruction is put firmly in the charge of the United Nations? Will he answer that straight question?

This country and the Government did not want a war. We did everything we could, very successfully, in terms of the preparation of Resolution 1441 and earlier efforts—

That is not true.

—and, unfortunately, we are no longer in the UN to continue that work. We engaged very actively in the food for oil system to try to help the Iraqi people. The Irish people, through our NGOs, are doing their best on the humanitarian issue.

Regarding pre-emptive strikes, all three countries gave official notification to the Security Council and set out the official reason for taking military action. They complied with what are the relevant criteria.

They wrote letters so it is all right.

That is the legal position under the UN Charter. They did not mention regime change. We always stated out position in the UN, that this war is not about regime change.

Tomorrow I hope the Minister will meet the US Secretary of State, Mr. Colin Powell, and others. Arrangements will be made for that meeting. We hope, on a European basis, to engage more proactively within the UN to see what we can do on the humanitarian issue. Deputy Rabbitte asked for a direct answer to a particular question, and anything we can do within the context of the United Nations to assist in the short term will be done.

Will the Taoiseach contact Kofi Annan on procedure 377?

It has been suggested to me that I and others should talk to Kofi Annan. A European effort will be made on this matter, but I am looking at that and we are trying to make arrangements in that regard.

Independent organisations reckon that the number of civilians who have died in Iraq is between 600 and 700, following the dropping of 10,000 US and British missiles, which slaughtered and horribly mutilated many others. How can the Taoiseach justify this war, which he has done in response to the previous question? The horror for civilians is largely sanitised by the despicable and sordid coverage of the international media networks. Has the Taoiseach taken the time to view some of the Arab television stations' coverage of the war? Has he seen their pictures of distraught men and women and traumatised children wailing over the broken bodies of their relatives? Has he been briefed on the massacre yesterday in the town of Hilla of 33 innocent people by the United States bombing of a residential quarter, when cluster bombs were used? This is a picture in today's newspapers of a father in Hilla grieving over the broken bodies of his babies.

Deputy, it is not appropriate to display newspapers.

How can the Taoiseach call weapons, that do this to human beings, sophisticated? Will the Taoiseach revise the definition he gave yesterday of what is happening in Iraq as a tragedy and call it instead extreme criminality? Will he say the leaders of the United States and Britain who are responsible for this are acting criminally? Will he instruct the Minister for Foreign Affairs to call in the British Ambassador and the senior United States envoy to register the revulsion and condemnation of the vast majority of the Irish people of the barbarism for which they are responsible in Iraq?

Some 120,000 more troops are being sent from the United States to Iraq. Can the Government be persuaded not to be complicit in this barbarism by facilitating them at Shannon and sending them on their way to drop more bombs, to kill more civilians and to wreak more havoc?

Deputy Joe Higgins knows what I have said about the humanitarian issue. What is happening is shocking. I despise war of any kind as much as anybody else. I have seen much of the filmed reports, some by the Arabian media. I have also seen filmed reports of some of Saddam Hussein's operations, including the killing of women, which are horrific. In balance, the Deputy should remember some of the anniversaries of past events – for example, we saw the film of more than 5,500 people who were killed by Saddam Hussein's weapons of mass destruction and chemical warfare some years ago. Many children died at the hands of his regime. All war and suffering is wrong but let us not look at only one side of it. This regime has killed one million people in a decade.

It did not stop the Government trying to sell him beef.

Within the United Nations we can play as strong a role as we possibly can to assist all the organisations and individuals who are involved in the humanitarian effort. We will do that in every way we can. There is already co-operation with UNICEF and many other organisations and we can do more within the UN. A huge amount has been done by the United Nations to help the aid programme. The UN is not sitting on the sidelines. It is deeply involved and it is necessary for it to be so.

I had an opportunity last night to talk to a number of my European colleagues. Working collectively with the United Nations we can do much more and we will endeavour to do that.

As usual the Taoiseach deliberately avoided all the crucial questions. Is there any end to the hypocrisy of this Government? The Taoiseach correctly referred to the barbarity of Saddam Hussein, but why was the current Minister for Transport, Deputy Brennan, doing deals with the beast of Baghdad on behalf of the Fianna Fáil Party seven months after the massacre of Halabja? How can the Taoiseach stand up here and lecture me with that stain on his party and on the Government of which he was a prominent member at that time?

Does Deputy Higgins object to food going to them?

No. 48a on today's Order Paper is in my name and that of seven Independent Deputies. Will the Taoiseach provide time for this proposed motion on Iraq or for a debate on Iraq this week? Does he agree that this is urgently required? Does he regret the Government's support for Resolution 1441 whose deliberate ambiguity was attempted to be used to give some kind of cover to the criminal invasion of Iraq by the United States and Britain? Is he revolted by the spectacle of massive US corporations organically linked to senior figures in the Bush Administration—

The Deputy's minute has concluded.

—that will be given billion dollar contracts to re-build Iraq. The people of Iraq will have their oil sold to pay for the bombs that obliterate them and their country. These corporations will then be given massive profits to re-build it. More oil will then be taken to create massive profits for these US-based corporations.

The Deputy's time has concluded.

As the leader of a country that suffered hundreds of years of imperialist plunder, how can the Taoiseach not take a stand against what these western powers are doing to the people of Iraq?

I ask the Deputy to resume his seat and allow the Taoiseach to reply.

The Deputy said I did not answer his earlier question. I said that the war under way is without doubt a terrible tragedy. We have seen the media reports—

I asked the Taoiseach about Shannon and—

(Interruptions).

Deputy Higgins is being disorderly.

—from Iraq that are distressing in the extreme. Ireland and the international community are working through the United Nations and we will continue to use our urgent search for solutions. I am not sorry that we put the effort into Resolution 1441. I gave the Deputy an opportunity but I did not lecture him in the way he lectured me. I gave him the opportunity to look at the intransigence of Saddam Hussein and see how he had acted for 12 years. Let us be frank, he had an opportunity. He made an agreement in 1991.

So the Taoiseach supports the war.

The Deputy should not try to twist it.

He broke it in 1998.

(Interruptions).

Deputy Higgins, the Taoiseach is entitled to the same courtesy as you were afforded asking your question.

Dictator regimes always do that.

(Interruptions).

I will be asking the Deputy to leave the House. The Deputy should resume his seat.

In 1998 he threw out the inspectors. He refused—

They were withdrawn.

He threw out the inspectors.

Tell the truth. They were withdrawn.

He threw out the inspectors and on every subsequent occasion—

(Interruptions).

They were withdrawn.

Deputy Michael D. Higgins is not a member of Deputy Joe Higgins's party. Allow the Taoiseach to reply.

—he rejected the efforts to try to deal with the situation peacefully and that is the truth.

The inspection process was shafted by the Taoiseach's friends who he supports by allowing them to come through Shannon.

Deputy Higgins should allow the Taoiseach to reply.

The entire world agreed on it as did the United Nations Security Council – 15 to zero. It is obvious that Deputy Higgins and others have problems with people agreeing to that, but they agreed on an international position.

The Taoiseach's minute is concluded.

Unfortunately, Saddam Hussein continued to decline it. That is the terrible tragedy but it is the reality and that is why we are in the current difficulties. As much as I abhor it that is the fact.

None of it is accurate. The Taoiseach is for the war.

No, I am not for the war. I am against all wars.

The Taoiseach is for the war.

Yes, the Taoiseach is for the war.

(Interruptions).

I do not take one-sided views on wars.

Neither do I.

Deputy Michael D. Higgins is totally out of order. We now move on to Taoiseach's questions.

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