The Government has demonstrated in recent times that it cannot be trusted on a number of issues. It appears incapable of making a decision without having a consultant on hand. Two reports on the health services, Report No. 119 and Report No. 120, will be published today. This country needs greater capacity in terms of beds, consultants, nurses and therapists. What will we get from the Government on a day when a major Dublin hospital has revealed that it may have to treat its patients in the car park and when Our Lady's Hospital for Sick Children in Crumlin has fewer beds than when it opened 50 years ago? We will get a glossy presentation outside the House which will distract from the lack of essential capacity in the system. The people will not be fooled a second time. The Government failed to deliver on a range of promises in this area over the past 12 months. Will the Taoiseach tell us this morning that the announcement later today will mean the Mater Hospital will not have to treat patients in the car park and that it will achieve more bed capacity in Our Lady's Hospital for Sick Children in Crumlin? How will it affect our Special Olympians, of whom we are proud, who will lose support and services later in the year?
Leaders' Questions.
Today is an important day for the health service. We are trying to ensure that we can do more for our patients, that we can get better value for the money we put into our health service and that we have a better and more accountable management system. Much work has been done over the past two years on the health strategy. Groups of national and international consultants have been involved, together with people in the day to day service and people from the health boards and the hospitals who have taken a direct interest in health matters. There have been sub-groups of all the professionals and several hundred people have worked for the past two years to bring forward a blueprint to update our health service.
We have not changed any of our structures since the early 1970s, which is 33 years ago, but we have resourced the health service. In 1997 I stated that we needed more resources in the health services and that we needed to spend considerably more money, and we have done that. The overall increase since I took office has been 162% or €5.7 billion, which is a lot of money. There is now 96,000 staff compared to 68,000, which is a 30% increase. There has been a 26% increase in the number of consultants and a 19% increase in the number of nurses. There are 58% more people in nursing training. Two thirds of the administrative staff are involved in front-line patient services.
Why are there waiting lists?
This is Leaders' Questions.
The waiting lists are down.
They are not down.
We are spending €2.54 million on health in the capital programme of the NDP.
The Taoiseach should answer the questions he was asked.
The reality is we are resourcing our health service and now we need to manage it better.
The reality is the Taoiseach is not answering the questions he was asked.
Allow the Taoiseach to reply without interruption.
The issue is that we get better service for our patients. Today's reports will be implemented so that we continue to get better service for our patients.
It is a whitewash.
The Opposition should study the reports and adopt considered positions on them. It should help in their implementation because it is important that our health service continues to develop. We are putting a lot of money into it. Every cent Deputy Kenny pays in income tax this year will go into the health service. That applies to every person in the country. Our entire income tax bill will be used to fund the health service.
No matter how much money is given to the health service, the Government still cannot manage it.
Today is about management.
There is no manpower policy.
Today is about bringing forward plans to give the people a better service.
Today is about saving the Government's skin.
Allow the Taoiseach to conclude without interruption.
Some Members of the Opposition will not read these reports because they are only interested in heckling me. However, most people will take an interest in and study today's report. We will try to implement it as quickly as possible.
We have all the reports.
Today is also about the protection of the politics of sham of a Government which has lost control and lost touch with reality. How does closing 500 beds or leaving Mullingar hospital empty for the past seven years represent efficiency and reform? Why is it that a political decision made to allocate 200,000 extra medical cards has resulted in not one being issued? Why is it that, while the Minister for Health and Children opened an eight bed unit in Beaumont Hospital last week, four beds are closed because of cutbacks? This is a protection of the politics of sham, the politics of promise and the litany of broken commitments around the country.
This party has no problem with real reform but the Government is confusing administrative change with real reform. The people will still face waiting lists and difficulties in hospital as a result of this. At the end of the glossy production and hype, what will the people have delivered to them? Not a single extra bed, not a single nurse, not one single extra medical card.
Deputies:
Hear, hear.
That is a double negative.
That is childish.
Deputy Kenny seems to be entirely negative about the health service so I will just ignore what he said and move on. I am interested in seeing that we have a better service for our people with more consultants, more nurses and more beds, lower waiting lists, better hospitals and more money for equipment.
Who will build the hospitals?
Please allow the Taoiseach to continue without interruption.
We will ignore those people who do not want to see genuine reform. We are seeing a far better service for our patients—
Who is not?
—and we will find the management structures to implement that over the coming years.
The Taoiseach has had six years.
We will build on the extra treatment we are providing with 180,000 more people being treated through far better services. There are practically no waiting lists in areas like cardiac surgery, cancer and gynaecology, for which there were enormous waiting lists five years ago.
What about the elimination of waiting lists over two years? Does the Taoiseach remember that promise?
That is the reality. In spite of the Opposition wanting to shout me down—
Allow the Taoiseach to continue. The Taoiseach is entitled to the same courtesy as every other Member of the House and I ask Members to afford him that courtesy.
I do not mind because they shout me down no matter what I say. However, the reality is I want to see a better health service for our people, and we will see that.
What has the Government been doing for the past six years?
The Government is bad for one's health. There should be a health warning about it.
The Taoiseach has been in office for six years.
Thank God.
He will produce another press conference later. After his first four years in Government he produced a health strategy, now largely abandoned.
That is a supposition.
We have had report after report from a Minister with an unerring instinct for the peripheral. I ask the Taoiseach to put today's announcement in the context of what it will do for patients. How will it improve patient care? There is no point telling us to read the report as we are the only ones who have not got it. How many of the 500 beds that have been closed will be reopened? How many new beds will be provided as a result of today's announcement?
How will it affect the Mater Hospital in his constituency, which I visited last week? How will it affect its plan to cater for emergency patients and ambulances in the car park? How will it improve the environment in which quality caring staff are functioning in impossible circumstances in the accident and emergency department of the hospital? How will it affect the care of children in Crumlin hospital where the provision now is less than when the hospital opened in the 1950s? I ask the Taoiseach to address the practical question of what this will do for patient care.
He proposes to save €1 million on the expenses of those who attend health board meetings, who comprise more than local politicians, and that is very good. The Minister for Finance, in a stroke for a constituent in the Finance Act, has cost the Exchequer €63 million potentially, according to the Department of Finance. This Minister for ideas when there is a full moon, the Minister for Education and Science, will cost the taxpayer €45 million to introduce electronic voting. What is wrong with the voting system we have?
Nothing.
This is another daft idea about us being at the leading edge of the intelligent island. It is absolute nonsense and blather with €45 million wasted. What will the grand announcement today do for patients?
Today's announcement is only about patients, by providing better patient care and using the resources we have more effectively. As we develop and expand resources in the years ahead, we can put more investment into our quality hospitals and those that are not up to standard. There is provision for an extra 3,000 beds in the health strategy. I have already given the statistics.
Most beds are being closed.
Please let me speak for two minutes. I have listened carefully to Deputies Kenny and Rabbitte. We are trying to develop and improve management and structures. Expert reports have been prepared for us. The experts are at the coalface of the health service day in, day out. They have outlined where we need to make fundamental reform to achieve better management and care so that we can use the resources we are providing and will continue to provide. This year, a difficult year, there has been a 12% increase in funding, almost €1 billion. All the taxpayers' money we collect goes into our health service.
Everything we do is designed to make the system more efficient so that the throughput of patients will be dealt with better and the operating theatres and ancillary facilities will be better. We are putting €2.5 billion into the capital programme under the national development plan. Spending next year will exceed €10 billion and will equate to several thousand euro for every individual in the country. We must make sure the services in Donegal and Kerry are as good as the services in Dublin. We must make sure there are equal resources. There is no point in having six consultants for one specialty in Dublin with none in Donegal.
We must make sure there is a national examination. The Hanly report will deal with staffing, the Brennan report deals with finances and the Prospectus report deals with structures. Several steering groups and sub-groups have interacted and worked closely together on all three reports over the past two years to try to bring forward a blueprint that will make our health system better.
It has taken six years to get there.
That is what today is about. I do not believe the health service will change overnight and I do not advocate that. It took us several years in the 1970s to build a service but it is in the interest of everyone who requires a service and pays for it that we try to get this right. I hope we can seriously deal with this issue and I thank the House for listening to me for two minutes.
The Taoiseach is making a nonsense of straightforward questions put to him here morning after morning. How can we talk about the Hanly report when the Tánaiste claimed during a debate last night that the Minister for Health and Children had not seen it? The only reports we have are an accountant's report, produced by the Department of Finance, which is important in itself presumably, and the report on structures. We do not have the key report on medical personnel, the consultants and nurses who work at the coalface. The Tánaiste said last night the Minister for Health and Children will conceal the report in the Department until the House has risen. The Taoiseach then gets up and, doe-eyed, tells the Ceann Comhairle that the Government is providing 3,000 extra beds. The 3,000 extra beds in the health strategy, according to his calculations, will cost €7.7 billion over ten years. The Government has provided €7 million so far.
The problem in the health service is the two tier system. What will this report do for access? What will it do for equity? What will it do for accountability? What will it do for value for money? Above all, what will it do for the patient? What will it do when the major acute hospital in the Taoiseach's constituency is making provision to treat emergency patients in the car park and sick children are less provided for in Crumlin than they were 50 years ago?
That is not true. That is rubbish. It is outrageous.
That is the reality of the performance over six years of the same two parties in Government, six years of political mismanagement at the top. Now the Taoiseach will sack a few councillors and that is supposed to be a solution to the health crisis in this country.
That is polemical.
That is not a serious contribution.
It is quite obvious that the Labour Party is not going to take much of a serious interest in this issue.
We would like to read the reports.
It never did.
All of the issues Deputy Rabbitte raised are seriously addressed in one or other of the reports. The only report that has not been published today is the Hanly report.
That is the important one.
The Hanly committee finalised its work at the steering group level last Friday week. It had to sign off with the various bodies.
Journalists have had it for the past six weeks.
I would ask Deputy Rabbitte to allow the Taoiseach to reply without interruption.
Deputy Rabbitte complains that I do not answer his questions but as soon as I try to answer he incites his party to shout me down. Will he just listen? If he just did that for a minute every now and then he would learn an awful lot.
The Hanly report was finished by the steering group last Friday week. The memorandum for Government is, at present, being drafted. It has not yet been signed off by the IMO. I hope that will happen and as soon as it does it will come forward. I assure those in the House who are genuinely interested that the three reports – Prospectus, Hanly and Brennan – have all worked together. They are all aware of what the others were doing. They are coherent reports on an overall plan which will, I hope, give reform.
The ERHA confirmed that there was no question of anyone being dealt with in a carpark of any hospital.
They already have.
I can also confirm that the Crumlin brief was moved on last year. Crumlin hospital is one of the finest children's hospital with some of the best medics in the world. It is renowned for that.
Despite the Taoiseach's best efforts.
They are hoping to continue on with the new development plan, which was cleared last summer.
Is the Taoiseach aware of the growing number of women who are now coming forward and are survivors of a barbaric practice carried out in Irish hospitals between the 1950s and the early 1980s? This procedure, known as symphysiotomy, was inflicted on 343 women at Our Lady of Lourdes Hospital in Drogheda. This is not the first time I have referred to what I can only describe as the mutilation of women who presented at that hospital in previous years. This practice was also carried out at the National Maternity and the Coombe Hospitals in Dublin.
My words are grossly inadequate to describe the pain and suffering these women have gone through and continue to go through. Their pelvises were sawn through, either immediately prior to or, in some cases, after the birth of their child.
Is the Taoiseach aware that this procedure was carried out, ostensibly because in these hospitals a strict Catholic ethos operated under the view that women should go through this procedure rather than have caesarean sections? The notion behind that thinking was that women, following caesarean sections would, God forbid, look at procedures of birth control or the option of sterilisation.
These women are calling for a full public inquiry into their suffering.
The Deputy's two minutes have concluded.
They are asking the Taoiseach and the Minister for Health and Children to provide the necessary resources in order that the full facts of what they suffered can be exposed and addressed. I add my voice to the call for him to respond positively to their request and their need.
The Minister for Health and Children tells me he has requested and, I think, received a report from the Institute of Obstetricians and Gynaecologists and he hopes to bring forward his conclusions arising from that. The chief medical officer of the Department has been working on this since April 2001. He is dealing with the matter.
The institute has advised that excellent results were claimed for the procedure at a time when caesarean section had a high mortality rate, due to sepsis. The institute says that, in properly conducted cases, complications were rare. However, from the 1950s onwards the operation for blood poisoning and obstructed labour was gradually replaced by modern caesarean sections. Enormous medical advances have been made over the last 50 years. I am advised that we must be cautious about judging procedures and interventions which were used in previous generations in light of current knowledge and experience.
The Minister has to deal with the report, which he has received. The chief medical officer will have to come forward with his views. The Minister has just told me he is prepared to convey the contents and some of the aspects of the report to the Deputy, who is obviously interested in the matter.
When my colleague, Deputy Morgan, last raised this matter in the House he got exactly the same reply from the Minister of State, Deputy Brian Lenihan, simply repeating what the obstetricians and gynaecologists have stated in their own statement of May 2001. The idea that we should not be asking questions about procedures employed in previous years, decades or whatever is unacceptable.
Will the Taoiseach instruct the Minister for Health and Children to respond positively to the appeal of these women? Will he acknowledge their pain and suffering and undertake to provide the necessary resources? Will he not depend on the obstetricians and gynaecologists who will have a particular view, but recognise that they do not have a monopoly of wisdom regarding the correctness of these procedures or other such interventions imposed on women, invariably against their will and in cases where many of them did not know what was happening? Will he so instruct the Minister for Health and Children and tell the House that he will support a full public inquiry into the obscenity that was visited on these victims?
I was not questioning the right of the Deputy to ask questions. I said we must be cautious about judging procedures and interventions used in previous generations in light of vastly increased knowledge and expertise.
They were questioned even then.
Deputy Morgan, this is Leaders' Questions. Aspiring leaders will have to wait.
It is your job I am after, a Cheann Comhairle.
Deputy Ó Caoláin will appreciate and accept that our one expert body, the Institute of Obstetricians and Gynaecologists, which has been greatly responsible for improving our knowledge and expertise over generations, should not be ignored. I am not saying people should not ask questions about the period. That is why the report has been prepared.
That anyone suffered at any time is a matter of concern to all of us. We know how medical advancement has progressed dramatically in the last ten years. There was a high mortality rate resulting from caesarean sections 40 years ago but that is now a very rare occurrence, and thank God for that and for the expertise of the institute and its members. The Minister has the report and is prepared to discuss it with the Deputy if he so wishes.