Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

The latest scandals in our crisis ridden health service and the failure of the Government to deliver radiotherapy show once and for all that the Taoiseach, Deputy Bertie Ahern, and the Minister for Health and Children, Deputy Harney, are unfit to govern. The ill-conceived, confused and mismanaged approach of the Government and the HSE, particularly in the provision of vital cancer treatment services, is a far bigger scandal than anything we have addressed in the Chamber today. As Deputy O'Sullivan stated, lives are being lost as a result of these failures.

Cancer patients are being denied lifesaving treatment because successive Governments have failed to provide the radiation oncology facilities required. This dire need has been recognised for many years and the Government has had ample time and a booming economy in which to plan and to budget for the provision of radiotherapy centres. Now, we find that the plan for delivery of such centres by 2011 is in chaos. The State could and should have taken the lead and provided them directly as public facilities open to all on the basis of need alone. Instead, the Government committed itself to public private partnerships to deliver them, but then it was found that these would take too long. A review was ordered and we now find that a delay until 2014 or 2015 cannot, allegedly, be avoided. The Minister for Health and Children has told us the planned centres may have to be provided entirely by the private sector, while Professor Drumm has told us the public sector can do it. Delay is piled upon delay and patients are dying in the face of a clear lack of uniform approach to these very pressing matters.

It must be pointed out that the current plan for radiotherapy centres is itself deeply flawed and leaves the northern half of the country with totally inadequate provision. Even this flawed plan, however, will not be delivered as promised. I heard the Minister in her response refer to the north west. I welcome the establishment of a satellite service or full service for radiotherapy in the north west which is what people actually want and need, but we must also talk about the north east where there is a blanket ignoring of the people's needs. It is not acceptable, especially where there is an opportunity for cross-Border co-operation in delivery. Cancer treatment service delivery is a complete shambles and is presided over by the Minister for Health and Children, Deputy Harney, and the Taoiseach, both of whom I hold equally responsible. The Dáil is the tribunal of the people, a very important point to restate. It is where the Deputies named should be challenged and held to account for their gross mismanagement and irresponsibility.

The Fianna Fáil, Progressive Democrats and Green Party Government is attempting to shirk its responsibility for the chaotic state of cancer care services. The mammography issue at Barringtons Hospital in Limerick — also referred to by the Minister — has exposed the failure of the Government to ensure that private hospitals are properly accountable. The Health Information and Quality Authority was established in legislation last year, but empowered only to monitor services provided by the HSE. It does not have powers to hold private hospitals fully accountable. While I pointed this out in the Dáil debate on the HIQA Bill, the Government chose to ignore it and ploughed on regardless. Through the infamous co-location scheme, the Government is encouraging the development of more private, for-profit hospitals without proper accountability. While none of them is present, I wonder if Green Party Members remember their opposition to co-location on which they are now very silent.

Fianna Fáil-led Governments have presided in the past decade over a catalogue of failures and delays in cancer care. These include the failure to roll out fully the long promised BreastCheck service, with many women having to wait until 2009 and beyond to get their first appointment. The Government has presided over the failure to deliver the long-promised radiation oncology centres and failed to plan radiation oncology services for other regions, including the north east, which has led to completely inadequate provision in the northern half of the island. This is compounded by the failure to ensure full cross-Border co-operation in cancer services. The Government has failed to establish national screening services for cervical cancer and other cancers such as prostate cancer. The Government has failed to heed the testimony of current and former patients and staff at St. Luke's Hospital in Dublin on the need to review the decision to close that centre of excellence. What is needed urgently is comprehensive public cancer care provided in the public health care system and available to all based on need alone, regardless of ability to pay and without discrimination based on geographic location. Nothing less is acceptable.

The motion comes as the Government presides over cutbacks in our hospitals, with the HSE acting as its enforcer. It has ordered the lay-off of 30 nurses and four consultants at Sligo General Hospital and no amount of trick-acting with words can take away from the real impact and effect of that decision. The Government is ending 24-hour accident and emergency provision at Ennis General Hospital and implementing cuts in Mullingar, Clonmel and Tullamore. These cutbacks have been imposed in the aftermath of a general election and in advance of a budget which promises more public spending restrictions. The Government has refused to use the unprecedented prosperity of the past decade to end the two-tier system and transform our health services.

The Government is now cutting services to patients. If the Minister, Deputy Harney, and Professor Drumm believe, as they claim, that these cuts will not affect patient care, they are clearly living in cloud-cuckoo land. The Minister and the chief executive seem to be losing touch with reality. How else can one explain Professor Drumm's assertion that the use of hotels is the way forward for our hospitals? The Government has ensured there will be no democratic accountability for these decisions. It has insulated the HSE from any responsibility to the local communities it is supposed to serve. The Minister, Deputy Harney, has insulated herself from proper accountability in the Dáil. These cuts must be resisted. I urge communities to mobilise to resist them and to turn out in the maximum numbers possible in Ennis on Saturday and at any future mobilisation which gives voice to the people's need in this critical area.

I welcome the two newly appointed health spokespersons for Fine Gael and the Labour Party. I have no doubt that the Minister for Health and Children, Deputy Harney, is delighted to see that I am still in that role on behalf of Sinn Féin.

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