Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

I propose to share time with Deputies Connolly, Catherine Murphy and Gormley. I have ten minutes, and I ask the Leas-Cheann Comhairle to indicate to me prior to the expiry of that time.

As the Government brings this Health Bill before the Dail, its health policy and its management of our health services is being exposed yet again as a shambles. As I mentioned to the Minister recently, the number of patients on trolleys and chairs in accident and emergency units reached 339 on one day already in 2007. When the task force report on accident and emergency was published last week, the Health Service Executive claimed a major improvement in accident and emergency but admitted it begins counting the waiting time for a patient in accident and emergency only from when a consultant decides to admit him or her as an inpatient. No account is taken of the time, often many hours, spent waiting to be seen by a consultant. The Government's cancer strategy is in disarray as exposed in the HSE report leaked last week. The Fianna Fáil-Progressive Democrats obsession with public private partnerships already mentioned here means that delivery of vital radiotherapy services is being delayed. The talks on a new consultants' contract are deadlocked and this is only January.

The Fianna Fáil-Progressive Democrats partnership has had nearly a decade to get health policy right and it has failed miserably. At the root of this is the Government's refusal to take a rights-based approach to health care. This Bill fails to vindicate health care rights. It is too little, too late. The Bill has been long promised and is long overdue. Action 63 of the Government's health strategy entitled Quality and Fairness — A Health System for You set a target date of 2003 for the establishment of the social services inspectorate on a statutory basis. This was to be in tandem with the establishment of the Health Information and Quality Authority. It took until 2005 for the Minister for Health and Children to establish an interim Health Information and Quality Authority. The Bill to establish the fully fledged authority and to put the social services inspectorate on a statutory footing is coming before us only now, in January 2007.

This legislation should not be enacted without another piece of equally long promised and long overdue parallel legislation. This is the promised Bill to provide "clear statutory provisions on entitlement to health and personal social services". This was the commitment given in the health strategy and the target date for publication of the Bill was 2002, five years ago. We still do not have that legislation and it is easy to see why. Such a Bill would raise many embarrassing questions for this Government about our grossly inequitable, two-tier, public-private health care system. If one sets out in law the entitlement of people resident in Ireland to health care, one must deal with the issue of health care rights and that is something this Government cannot face. It refused to enact rights-based disability legislation and it is refusing to enact rights-based health care legislation.

The interim Health Information and Quality Authority published its first newsletter in December 2005 and stated its purpose. It said it will "assure the delivery of world class health and personal social services". That is a very tall order indeed. To thousands of people who experience the reality of our health system today it must appear as a very sick joke.

A world class health service has been the repeated promise of this Government, but what have we got instead? We have got a two-class, two-tier health system that is inefficient because it is inequitable. I have already cited the health strategy, which has been effectively abandoned by this Government. In 2001 it stated that greater equity for public hospital patients would be achieved through a revised contract for consultants. The target date was the end of 2002. Here we are in 2007 and the talks on the contract have barely got past the starting post. To their shame, that section of consultants which runs the Irish Hospital Consultants Association is holding out in defence of what I regard as the indefensible, the so-called category two contract which allows consultants who are paid generously from public funds to provide care to public patients in public hospitals to also carry out private work for personal profit in a variety of settings, including private hospitals and clinics. To its shame, this Government and the HSE are preparing to make further concessions by allowing consultants working in public hospitals to spend more time treating private patients in those facilities.

All this comes as the Minister for Health and Children continues to pursue her scandalous scheme to privatise hospital services by providing land at public hospital sites to developers of private hospitals. This is on top of the massive tax breaks the developers will receive. The Government has no mandate for this privatisation plan and it should abandon it now.

The Health Information and Quality Authority is tasked in this Bill with setting standards on safety and quality in relation to services provided by the Health Service Executive and to monitor compliance with those standards. Will it apply different standards to the public and private systems? The reality today is that different standards do apply, and this Government and all its predecessors have perpetuated such a manifestly unjust system. How will this authority work if the two-tier system is maintained and is allowed to continue?

Anyone who doubts the injustice of the system and the fact that injustice in health care delivery costs lives should read the letter from the cancer patient in Kilkenny sent to RTE's "Liveline" on 9 January and widely publicised. This cancer patient has been told by her doctors that she has only a few short years to live. Her life could have been saved if she had access to a colonoscopy. She visited her GP in the summer of 2005 and was referred for the procedure, but she did not get that vital diagnostic procedure until 28 February 2006. It was found that she had bowel cancer and the cancer had spread to other organs.

On her 12th session of chemotherapy, the Kilkenny cancer patient spoke to the partner of another patient. She told her that her partner's GP had requested a colonoscopy and he was put on a waiting list. She then phoned the hospital and told them she had private health insurance and he got that colonoscopy within three days. The cancer had not spread and his life was saved. I wish to put on the record sections of what the Kilkenny lady had to say to the people of Ireland and to this Minister and this Government:

I then came home, flicked on the tv and got into bed. The first ad on the tv was from the government telling people that bowel cancer can kill, but not if caught in time. If Bertie Ahern or Mary Harney or Michael McDowell were within reach I would have killed them.

She concludes her letter:

Despite one and a half incomes we couldn't afford VHI or BUPA. But if we could we wouldn't have gotten it because we believed (and still do) that all people should get good care despite their incomes. We thought jumping queues was wrong.

Many people in this country agree wholeheartedly with the sentiments of that lady. I make no apology for placing what I regard as that eloquent indictment of this Government's health policy on the Dáil record today.

What will the Health Information and Quality Authority do for a patient like that? In a nutshell, inequity of access is the flaw in the system that is literally killing this woman. Apart from her experience of the Mater hospital, which she describes as "filthy and squalid", she does not complain of the treatment she received from the health services when she finally got treatment. However, the system failed at its most vital point, the point where it should have provided early, life-saving diagnosis.

This woman's experience is replicated by thousands up and down the country. Because the Health Information and Quality Authority will not be based firmly on legislation enshrining the right to equal access for all patients, it will have no remit to examine why this woman did not get immediate access to the early diagnosis that probably would have saved her life. We are not even clear if and how it will be able to examine individual cases.

I had other points to make but I will conclude. This Bill can be no substitute for comprehensive rights-based health care legislation. We in Sinn Féin base our approach to health on the principle that everyone has the right to timely and appropriate high quality health care that is available in sufficient quantity and accessible to all without discrimination. I commend that approach to this Minister and to this Government. It is never too late to row back from the perpetuation of the inequalities that she has presided over since she has taken over this Ministry and which she and her colleagues have presided over since 1997.

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