HEALTH (Disability, Drugs & Alcohol) and SPORT

Each speech listed here is an edited speech. If you'd like to see the speech or debate in full, please go to the Oireachtas website and click on "Seanad Eireann" and then "Seanad Debates" and click on the relevant date as listed with each speech on this page.


Health (Amendment) (No. 2) Bill 2010 (30/06/10)

Archbishop Martin’s Speech – Clerical Abuse (11/05/10)

Headshops (11/05/10)

Minister for Health and the Tallaght Hospital X-ray Reading Fiasco (11/03/10)

Minister for Health and Tallaght Hospital X-Ray Reading Fiasco (10/03/10)

Good Friday Alcohol (09/03/10)

Children’s Welfare (02/03/10)

Head Shops (03/02/10)

The Murphy and Ryan Reports (27/01/10)

Head Shops (26/01/10)

Monageer Report (27/05/09)

Ryan Report - Statements (27/05/09)

The Ryan Report (27/05/09)

The Ryan Report (26/05/09)

The Ryan Report (21/05/09)

HSE-Ombudsman for Children Dispute re Child Protection Audit of the Catholic Church Dioceses (06/05/09)

Health Bill 2008 (Medical Cards Issue) (12/12/08)

Stem-Cell Research (Protection of Human Embryos) Bill 2008 (26/11/08)

Nursing Home Standards (05/11/08)

Medical Cards (05/11/08)

Mental Health Bill (30/10/08)

Stem Cell Research (29/10/08)

Human Body Organs and Human Tissue Bill (01/10/08)

Cancer Services (02/07/08)

Alcohol Advertising (Broadcasting Bill 2008) (25/06/08)

Stem Cell Research (20/05/08)

ALCOHOL – Drink Driving Limit (24/04/08)

Portlaoise Hospital Report (06/03/08)

Emergency Contraception (27/02/08)

HSE (26/02/08)

Health (Miscellaneous Provisions) Bill 2007 (19/12/07)

Motion of No Confidence in Minister for Health (28/11/07)

Pharmacist Negotiations and Pricing (22/11/07)

Cancer Services - HSE (20/11/07)

GAA and GPA - Players' Grants (14/11/07)

Hospital Hygiene (13/11/07)

Health Services and the HSE (08/11/07)

Health Services and the HSE (07/11/07)



Haemochromotosis (30/06/06)

Stem Cell Research (29/06/06)

National Sports Campus Development Authority Bill (27/06/06)

OECD Report on Health Services (27/06/06)

Public Hospital Lands and Consultants (31/05/06)

Accident and Emergency Services (09/05/06)

Recommendations of Lourdes Hospital Report (04/05/06)

Screening for Hearing Disabilities in Newborn Babies (06/04/06)

Cancer Services (23/03/06)

Cancer Services (22/03/06)

Lourdes Hospital Enquiry (09/03/06)

Medical Council (23/02/06)


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Health (Amendment) (No. 2) Bill 2010
30/06/10 - I supported the Bill on Second Stage, not because I am in favour of a charge for prescriptions but because when the an bord snip nua report was published, I was appalled at the figure of €5 proposed. The position taken by the Minister in the legislation is not unreasonable from that point of view and is a major improvement following the shock we got at that stage. I take on board … that this measure might cause hardship and that is my only reservation about it. I am not sure whether the Minister can make regulations in a later part of the section we are discussing to vary the position on the basis of a financial burden or hardship being imposed. The answer is to review the measure and come back to us with the results. Also, there should be an appeals mechanism which I understand may already be in place for those experiencing hardship and poverty.

… there is overuse and abuse of medications, not in the sense of people shooting up but misuse. I have argued with the Minister many times about the money being wasted. Often the things people get for nothing are regarded as having no value. I realise that is the speech made by my grandmother, but there is an element of it in this instance. The perfect solution would be for the Minister to hold the charge and have an appeals structure in place.

….. I was cited the example of someone living 40 or 50 miles from Dublin who had genuinely lost their child’s medication. The person concerned telephoned to get a repeat prescription … insisted that it be sent by taxi, even though they had a car. That is the other side of the story. I am not using this story to undermine the valid arguments made by my colleagues on this side of the House but to support my position that there is a number of people who take the health service for granted and do not recognise that it is taxpayers’ money. It is our money and the way it is spent is important. It is important that it is spent properly.

My point to the Minister is that it is not unreasonable to have a charge. Neither is it unreasonable … that there be a review of the charge and that there be in place a fail-safe mechanism to ensure nobody’s health will be compromised in a manner not contemplated by the legislation and certainly not by the Minister. …. I would like to say I am opposed to the Bill on principle because it imposes a charge, but I find that to be an unreasonable position in terms of where we are.

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Archbishop Martin’s Speech – Clerical Abuse
11/05/10 - …. the need to look again at the Ryan and Murphy reports. I was astonished at the extraordinary words of Archbishop Martin last night. That he is able to say there is still denial about the extent of child abuse within the church blows me away. I find it hard to come to terms with this after all we have read and seen. He has told us with great courage that he knows there are people within the church who would prefer if the truth about child abuse did not emerge. We can only conclude that we have not heard all of the story and that there are forces within the church who are determined to conceal the truth. That is astonishing and the archbishop deserves any support we can give him. He needs to bring the matter further. … I thought things could not get worse and that we had heard everything, but that there is still more we have not heard and that there are people who are determined to conceal the truth is more than I can accept. The archbishop should allow his words to seep through the structure of the church and society for the moment and let people change their ways, after which we deserve to hear the full facts about obstructionism or non-co-operation in the church or anything related to it. I am not simply talking about members of religious orders or the clergy. These are crimes that are being hidden and it is important that we get to the bottom of the matter and acknowledge the points made.

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Headshops
11/05/10- … I would like to congratulate the Minister (for Health and Children) for dealing with the head shop issue …. Her response is a simple and effective way of dealing with it. It may well be challenged in the courts, but it is a very good start. …. I congratulate … Ms Grainne Kenny who has done so much work on the issue and brought to our attention what was happening in eastern Europe. It is important to acknowledge that this step provide relief for many anxious parents and communities.

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Minister for Health and the Tallaght Hospital X-ray Reading Fiasco
11/03/10 - Let us be clear about what we are doing, what we need to look at and where responsibility should lie. There is a medical team which needs to answer questions, a management team which looks after that medical team, the board of Tallaght hospital, its chief executive, the HSE, the Minister and the Department of Health and Children. There are at least five stages of separation between the Minister and what happened. We are not doing the patients who are suffering and the victims any good by focusing on her. If the Minister was responsible and wrong in what she did let us point to that but blaming the Minister for something that happens on the ground demeans politics.

We can ask ourselves questions on this. People have been speaking about the size of the board of Tallaght hospital. Those of us on the Independent benches insisted on a large board as did other Members of the House. There were good cultural, religious and other reasons that people wanted a large board. It was probably the wrong decision because a 20 person board is too big but let us all remember where we were when it was established and what jobs we gave them. The Minister appoints people to do a job; if they do not do that job it is they who are answerable in the first place. If the Minister asked them to do the wrong job then she is answerable. An audit would show this very clearly and we need to do justice to the victims by dealing with this matter properly.

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Minister for Health and Tallaght Hospital X-Ray Reading Fiasco
10/03/10 - We should not waste the time of the Minister for Health and Children by requesting her to come to the House to deal with the matter raised. It does not reflect malaise or apathy on her part that there were problems among medical staff, including clinicians, physicians, radiographers and others. It is time we had a debate on the difference between accountability, responsibility and related matters and on the role of a Minister.

The role of the Minister is not to read X-rays or run hospitals but to ensure they are run as well as a Minister can so ensure and that if problems arise, they are dealt with. Blame cannot attach to the Minister in this matter. That is a disinterested independent view. What has happened is absolutely appalling. I understand what the Opposition parties have to do and do not blame them for so doing because Members on the other side of the House would do the same. … We do not do ourselves justice in carrying on like this. While we need answers, we also need to recognise and understand what it is a Minister is supposed to do. If anybody believes having a different Minister in the Department of Health and Children would change matters at hospital level, that is not the way it happens. We should consider this point.

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Good Friday Alcohol
09/03/10 - I refer to the Intoxicating Liquor Act 1926 which prohibits licensed premises from opening on Good Friday. As public representatives and legislators, we must examine the reason pubs and restaurants cannot sell drink on Good Friday. Was this prohibition introduced in the interests of the State or to meet the needs of the churches? We need to know where we stand on this issues. Amending the legislation to allow licensed premises to open on Good Friday, especially in Limerick for the match between Munster and Leinster, would be a win-win scenario. I want to make clear what we would be doing in changing the legislation. I am not having a go at any church or believer, but if we were to change the legislation, the net effect would be that while churchgoers and believers could abstain from alcohol on Good Friday on the direction of their church, meanwhile atheists, agnostics, sceptics, heretics and others could imbibe should they wish to do so.

Everyone would be a winner and free will would prevail. The separation of church and State would be maintained and we would render unto Munster the things that are Munster’s and to God the things that are God’s…..In that way the industry would gain, we would save jobs and the economy would gain. In addition, it would reflect everyone’s point of view, while not trampling on anyone’s beliefs.

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Children’s Welfare
02/03/10 - A case that was going through the courts concluded yesterday. I do not wish to discuss it but its outcome. A young man described his extraordinarily torturous home life during which he was raped, assaulted, oppressed and humiliated daily. This happened between 2001 and 2004 when he was a child of 12 to 15 years of age. In 2001 the HSE was concerned about his welfare and that of his siblings and sought to protect them from the worst excesses of his family. At that stage there was an intervention by a right-wing, religious organisation which took court action and delayed the intervention of the HSE. Consequently, the children were not taken into care until 2004. The events during that period which had everybody sick and almost vomiting as they listened to reports in the last couple of days happened because a right-wing religious organisation interfered when the State saw the need for protection. We should consider inviting the Minister of State with responsibility for children to the House to debate not just the constitutional rights of children which we debated last week and should revisit, but also legislative protection and powers for the HSE and other State bodies to intervene when they believe children are at risk. As legislators, we are quick to point out when the HSE and others are slow to intervene. This is an example of where its intervention was blocked by our legislation. As a consequence, children suffered rape, victimisation, humiliation and constant assault.

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Head Shops
03/02/10 - We have examined this matter for years. …. I have long believed there should be a two-pronged approach focusing on both supply and demand. All the media comment tends to be on demand. In this regard, it was very good today to hear so many Senators focusing on education and advertising. We must have learned over the past decade that no matter how much legislation we put in place, as we must, and no matter how many resources we put in place, including Garda and customs resources, there is no doubt but that there will be a supply line as long as there is demand. While one could never hope to solve the drugs problem through targeting the supply line alone — drugs will always be brought into the country — one could hope to solve it permanently by focusing on demand.

A contrarian view can be applied to many parts of the problem. While one cannot make a logical case for decriminalising certain substances, it may be the case that certain drugs could be controlled better if their use were not a criminal offence. If it were not a criminal offence, we might see where the problem is happening. Let nobody believe I am suggesting that we decriminalise hard drugs and other drugs; that is not the point I am making.

We must put in place legislation that will deal with the way head shops are operating. Much can be done through ordinary planning-type approaches and by requiring the shops to at least meet certain minimum requirements, as would any other business. We do not seem to be considering this at all. We need solid legal sanctions, where necessary.

For me, it is a question of education and increasing the knowledge of young people. It is about challenging their attitudes and developing their skills and self-confidence such that they will say “No” and feel they do not need to take a drug. This is the real challenge. It is a societal matter and cannot be resolved by any one approach.

We have learned many times that the risk issue is irrelevant. That people can get killed using drugs is of no value whatsoever in drugs education. If anything, risk is an attraction to many people, including the young. ……… Therefore, we have to give accurate and honest information. We cannot tell people, “This will kill you,” if it will not because they are smart enough to know otherwise. There has to be honesty. Parents and teachers must be brave enough to challenge the attitudes of those who are using drugs or tempted to do so. We also need to examine the relationship between drug use and what it does to communities, families and homes over generations…. . If, however, it is explained to them what drugs can do to their families and if this is built into a properly structured programme, something can be done about the problem. In addition, we need expert support at all levels to identify those moving into the shady area of drug abuse.

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The Murphy and Ryan Reports
27/01/10 - The Murphy and Ryan reports have been sitting there for months on end. I do not know where the Government is in terms of implementation. I do not know what results or consequences we are dealing with. I have raised the question of the involvement of the churches in primary schools, the connection between school patrons and clergy about whom there might be complaints and the conflict between being the school patron and the shepherd of the flock. I do not want this to be interpreted as anti-anything; it is the reality. Everyone dealing with schools, children and education should be vetted properly and correctly. The idea of not making any change and not having any restrictions or rigours imposed on patrons and chairpersons, such as bishops and parish priests who are patrons of schools or chairpersons of the boards of management, shows a lack of confidence in the system. It is not just I who say this. Clergy also say it and the Archbishop of Dublin has raised this issue. We need to see the consequences and we must ask what we have learned from the Murphy and Ryan reports and others to come. What will we do about them? It is a shame if we do nothing about this. This House could make some movement on the matter.

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Head Shops
26/01/10 - It is fair to say that what we are discussing is high street drug peddling. While “head shops” might not be breaking any law and are, de jure, legal, de facto they go against everything contemplated in the control of substances. As someone who worked for many years in Irish and European anti-drugs structures, this is appalling. In order that people will understand, we are discussing circumstances where minor changes are made to substances which are then made freely available on the high street. There can be psychotic and damaging consequences for young and old people of all descriptions. This not only leads to difficulties for society but also to deaths. It is beyond belief and totally unacceptable that such substances are not controlled. I have studied this area again during the past week. The substances in question are far more dangerous than some of the items outlawed by legislation. ……. although there may not be crime involved. The issue must be dealt with, regulated and controlled immediately.

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Monageer Report
27/05/09 - I remember chasing up the background to two horrific murders about 15 years ago. One of them was a murder in Clontarf where a man in his own home disturbed a burglar and the burglar hacked him to death with a golf club or some implement that was nearby. .. I found out that when he [burglar] was four years of age in junior infants class, his teacher and his principal asked for a psychological assessment. Before he reached 11 years of age, that school twice pleaded for support for that child from a dysfunctional family, claiming that he was clearly heading for trouble, and he committed murder afterwards. Nothing was done…… Another well known case was that involving Brendan O’Donnell in Clare. He murdered a mother, a child and a priest. In junior infants, the school authorities expressed their concern about him. He used to lie on his mother’s grave in the middle of the night when he was four, five and six years of age. The school asked for help and support, but it was not there.

I put these examples forward to back up the point … about the need for early intervention and to deal with issues in an appropriate way. They also highlight the need for mandatory reporting. .. The two examples showed that the schools took the initiative, even if it did not do any good in the long run. .. There should be consultation at school level where all the different groups involved in dealing with a difficult child come together.

I wanted to hear why he [Minister] did not publish the report in full. … There are certainly plausible arguments to be made for not naming people, but I do not understand why the format for the Ryan commission report was not followed. Pseudonyms could have been used and we could have left it at that, so that we could at least read what the report was saying. .. There is nothing that destroys and dilutes the impact of a Minister faster than legal advice. .. It is only advice. The legal people are not politicians and they are not answerable to the people.

If public representatives are to learn from this, they must be able to read the report. I accept the argument that they do not need to know the names of the people. However, they do need to know how the process worked or did not work. There is a certain offensiveness in the Minister of State saying even a committee elected by the people to deal with this issue cannot be told.

While I do not know what is and is not discoverable, I do know that no judge in the land, recognising the clear distinction and separation of powers between the Executive and the Judiciary, would find against a Minister if he, she or the Department argued they made available documentation to an appropriate committee of the House in confidence.

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Ryan Report - Statements
27/05/09 - I will begin by looking into the future ….. and put five simple facts on the record. Recently, the Irish Mental Health Commission stated that 247 children are wrongly incarcerated in adult mental institutions throughout the State. The Irish Society for the Prevention of Cruelty to Children reported that last year it took more than 600,000 calls for help but because of a lack of resources it was able to respond to fewer than half of them. Over recent years 360 non-national children were lost by the HSE. They were on the records but now they have vanished and we do not know whether they have absconded, have become sex slaves, were killed or have left the country. Residential homes and institutions for children with intellectual challenges are exempt from inspection but surely of all groups they should be included. There is a current court case concerning the murder of a 14 year old child who was on our list of at-risk children but who was dead for more than a year before anyone thought to look for her. This is how we cherish the children of the nation equally as proclaimed by the Constitution and it is worthwhile putting this on the record prior to stating anything else.

People may not like what I will state because I will refer to some of the shady and sinister Catholic organisations to which I referred last week. … . I want to put on the record, without fear of contradiction, that every single proposal I ever brought forward on child protection was opposed left, right and centre, and I will provide the House with some examples. … One issue was the Stay Safe programme, a very simple programme to help children and which is in primary schools at present. That is one issue. Sex education programmes is another. Mandatory reporting is another. For six years I called for mandatory reporting in this House until I got tired of doing that. Nobody wanted to know. All I heard were the problems it would create.

The Stay Safe programme was being developed by two women, a psychologist and a medical doctor, for the then Eastern Health Board. The funding for their project was withdrawn through the influence of the Knights of St. Columbanus. I recall going to the executive of my union, the Irish National Teachers’ Organisation … the national executive voted £10,000 .. to allow those two women finish their programme, which they did. They prepared an excellent programme. I then went to the Minister of the day, Deputy Mary O’Rourke…. She said it appeared to be very important and progressive and something in which we should get involved. … she told me she would run into problems in her own Department. … she and I met with the crucial people. We brought in the most senior person in primary education and the head of psychology in primary education and the two women who developed the course. We asked the two women to make the presentation. Having made the presentation and knowing all the problems that would arise we had a discussion on the position. We looked at this man, who was a senior Knight of St. Columbanus and the most senior person in primary education, who had various reservations about the programme. … The officials highlighted the problems that might arise but the Minister said it was a solid programme to protect children and .. she said she wanted it in the schools. It took years for the programme to get into schools but it would never have got into them without her.

When the Stay Safe sex education programme was being brought forward I was not in Dublin. … there was a crowd of weird people picketing our bungalow out in the country. One can imagine the words on the placards, and they were shoving various pictures, imagery and items in bottles at my three daughters. ... They (Gardaí) told me who the groups were — Family Solidarity, Youth Defence and three or four others, all people that we knew.

Nobody gave children a chance. When it came to dealing with the issue of mandatory reporting in this House a new concept was discovered. Who remembers the great concept of false memory that was developed by those right-wing Catholic organisations? The way it was proved that children should not be believed was by telling them that what they remembered was not true.

Can somebody tell me why we as politicians have to disclose all that we do in terms of our backgrounds etc.? We have to sign this form and that form. We have to declare an interest if we speak on something here. … but at the same time secret organisations such as the Knights of St. Columbanus and Opus Dei can do what they want.

I took the trouble to meet with Opus Dei years ago and it is written into their requirements that they should try to impose the beliefs of the organisation on their jobs. I raised the issue here years ago that people being appointed to jobs of sensitivity in areas like the Attorney General’s office and others should be asked the question about membership. …There is no place in an open, transparent democracy for people who have other agendas.

… The same man [Bishop Brendan Comiskey] went to Wexford where he was in charge of all the problems in Monageer. When the Wexford People and the Wicklow People newspapers honestly and openly reported the conviction of a priest there for paedophile activity, he and the Knights of St. Columbanus attempted to boycott the People newspapers. ..That is on the record. There was also the horrible incident when there was a complaint and an investigation regarding a priest in Monageer having sexually assaulted a child. The priest insisted on doing the First Communion or Confirmation two weeks later. The people appealed to Bishop Cumiskey to stop the priest doing so, but he insisted. This man was up on the altar for the event.

That incident was investigated by the local Garda sergeant, who did a very good job. His chief superintendent insisted on getting the files and nothing else happened. …. As a result, the then Garda Commissioner appointed an outside chief superintendent to investigate the matter. He came to the conclusion that the local investigation had been well done but the matter had not been properly brought to a conclusion. The files were lost. The files were in the gift of the chief superintendent who was a senior Knight of St. Columbanus in the area. He retired, received his Benemerenti medal from the Pope and took his secrets to the grave. The priest was never prosecuted and the matter was never brought to a conclusion.

I am only starting what I wish to say in this debate. … I reject calls for balance in this debate. There is no balance. This is about imbalance. It is about power and influence hammering, raping and brutalising young children. There is no balance in that and there never will be. However, I must finish by stating there are decent, good and honourable people in the clergy and the religious orders who have been tainted and hurt by this. We stand by those people. …. but there can be no balance about the imbalance in how these children were treated.

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The Ryan Report
27/05/09 -If there is to be a report [Government response to Ryan Report], it should be a report to the Houses. Nobody here can justify a situation where we are not involved in and responding to this issue. No matter whether the report comes in July, August or whenever — it should be early rather than later although I am prepared to listen to the Government’s reasoning on why it should take two months — and whatever the reason, any politician who feels he or she should be on holidays while this business is being dealt with reflects poorly on all of us. … Whatever the other House decides, this is another example of where the Seanad can be seen to do business, engage with topical issues and show a public political response. … . Whatever the situation, I want the report discussed here.

I also ask that amidst those proposals would be a Government decision to have a day of remembrance, probably annually, for the victims of this. Time will show this is a fulcrum in our development as a State and we should not allow ourselves or succeeding generations ever to forget it.

I ask that a Government warning hang on the Christian Brothers’ commitment, as they called it yesterday afternoon. ….. I want to give the Leader one salient fact and I ask that this be kept in mind by everybody who speaks on this issue. In 1991 the Christian Brothers in Canada had assets to the value of €100 million. The order squirrelled it away into trusts. We, as politicians, know that to dissolve a trust needs an act of parliament. … When it came for the order to pay up in 1996 that €100 million had been reduced to €4 million. That is what we are facing. The order has already set up a trust. I do not have confidence in what Brother Edmund Garvey stated in the past couple of days.First, the Government should ensure the order pays up, as the order is leading us to believe without saying so. Second, if there are moneys to be made available, they should not be made available by a charitable route or conduit from the Christian Brothers to deal with the same people who were their victims decades ago. It should be dealt with independently and away from the representatives of the perpetrators.

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The Ryan Report
26/05/09 - … it is very important for us to articulate a clear view that in terms of responsibility, the congregations — the 18 orders — and the State should share the cost equally. It should be a 50-50 response. To those people who ask if we want to start selling the schools and hospitals, the answer is “No”. However, I want the deeds of those schools and hospitals transferred to our ownership until such time as we make up the amount that will be needed. I do not want them sold, disposed of or liquidated, I want them transferred into our ownership to allow a 50-50 share of responsibility and cost all the way through.

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The Ryan Report
21/05/09 - It is not just the churches, although I shall come back to that. There is the clergy and the churches, the State, politicians, the Judiciary and the media. All of us have questions to answer. We have provided an enormous carpet under which all of this was swept and hidden. We need to look at the common bonds. I want to put on record where I believe an enormous element of the problem lies — I know what my phone is going to do after this — namely, with the pervasive influence of those secret, shady, sinister, right-wing Catholic organisations that have been in the middle of this all my working life.

I can give the House chapter and verse and name the people who stood in the way of the Stay Safe programme, mandatory reporting, sexual education programmes in schools and I could go on. These people did the same here in education in some of the high offices of State and managed to carry the day. They have escaped in the course of these reports and I certainly believe they have much to answer for. There are people in this and the other House who can back up what I am saying.

… Excuse me if I have a curl in my lip when I think again about all that spurious, specious argumentation being put about by these groups about destroying the innocence of young people at a time when they were being destroyed and wrecked and their lives, not just their childhood, was being taken from them in these institutions.

We have a great deal to answer for. I would like this investigation to go further to see where these influences were brought to bear on the Department of Education and Science, other Departments, Governments, media and on the church to ensure this thing was never dealt with when it should have been.

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HSE-Ombudsman for Children Dispute re Child Protection Audit of the Catholic Church Dioceses
06/05/09 - I propose an amendment to the Order of Business. …. I suggest that time would be better spent discussing the row between the Ombudsman for Children and the HSE rather than swine vesicular disease, which the Government is handling very well. That is my amendment to the Order of Business.

There is a lack of information. Subject to being corrected, it is my belief that the problem is that the HSE has documentation it got half-filled by the Roman Catholic Church which refused to give the full information in the Ferns and Dublin investigations. This is the documentation solicitors and lawyers for the Roman Catholic Church are saying may not be made available to the ombudsman. To the public eye the ombudsman and the HSE are involved in a row. I would like to get it all out in the open.

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Health Bill 2008 (Medical Cards Issue)
12/12/08 -I oppose this appalling decision, which has caused hurt, chaos and worry among many elderly people who have given their lives and made a considerable contribution to the country. It is a sad end for them.

I wish to raise a number of issues. … Regarding gross and net amounts, it is appalling that the Government softened the impact of the change by making some important decisions. When someone told us it was a gross figure, we pointed out that the net amount used to be the figure taken. According to the website of the Department of Finance, which was stunningly unsympathetic, devastating and stupid to the highest order, the gross figure is being used because people understand it better than a net figure. At a time when everyone was uptight concerning this issue, I could not believe that such a flippant answer to a serious question could be given. It was harsh.

I listened as the Minister (Deputy Harney) discussed another aspect of the matter… she stated that nursing home charges might be taken into account. …. . Will the Minister of State elaborate on these issues?

People are not trying to rob the State. Those in question have paid into their pensions for all of their lives and looked after their futures so as not to be a burden on the State. They take their lifestyles and contributions seriously, but now feel discarded. Anything that can be taken into account in this important issue should be considered. The people to whom I refer are discovering that they may lose out because they have pensions. Those who are obliged to pay full nursing home costs and who earn €40,000 per year would be better off if they did not have pensions.

I wish to put a straight question to the Minister of State. I have already posed a number of questions and I know she will respond to each in a diligent manner. When the measure to which the Health Bill 2008 relates was put forward in the budget by the Minister for Finance, it was the subject of much discussion. … The cost to the State of medical cards for the over 70s was €650 per person per year. The concept behind the Bill is to reduce that cost. If a person offered to pay the State €650 per year, could he or she effectively buy a medical card as a result? … If they paid the money directly, it would almost provide them with a form of insurance. Will the Minister of State comment on this matter?

On universal access, the arguments put forward by those on the Government benches with regard to millionaires receiving medical cards are spurious. No one on this side of the House is of the view that millionaires should be entitled to medical cards. .. We were of the view that there are certain things to which people, as members of society, are entitled and … to which there should be universal access. … Such access should also apply in respect of health services for those who are over 70. It is not a question of millionaires taking advantage of the system. … In a society which operates on the basis of equity, a platform should be provided to all citizens in this regard. That is the basis of universal access and the way it is paid for is through taxation. If someone pays his or her taxes in this country, then he or she should have an entitlement.

On many previous occasions I referred to the question of numbers. … we obtained figures relating to the health service it was in reply to a query regarding the number of people over 70 who would be entitled to medical cards. I do not need to revisit that debacle with the exception of stating that we never received a final indication as to the number of people who would be so entitled. However, everyone agrees that the Department of Health and Children completely underestimated the position. I make this point because I do not believe that there are only 20,000 people over 70 years of age who will not quality for medical cards. On the basis of the evidence I have seen in this regard, the figure of 20,000 cannot be accurate.

I would like a breakdown in respect of the supposedly only 20,000 people over 70 who are not entitled to medical cards. How many retired teachers, nurses, gardaí, civil servants and private sector employees are involved? If someone can inform me that the total number is under 20,000, I will be absolutely amazed. I have spoken to people involved with the Retired Teachers Association and individuals involved in banking and the Civil Service. The estimates they provided indicate that the number of people who will be affected is well in excess of 20,000.

I request that the Minister of State reply in respect of the questions I posed in respect of those who are over 80 and the possibility of the Government raising the threshold to €40,000, €45,000 or €50,000. A development in respect of either of these matters would make a major difference. The Government should show sympathy to those who are concerned about this matter and who are of the view that obtaining a medical card would have a major impact on their lives.

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Stem-Cell Research (Protection of Human Embryos) Bill 2008
26/11/08 - For the record, I have done everything possible to have this matter raised on the floor of the House. I believe it is crucially important that we engage with these issues. I do not purport to be an expert. I have read the Bill a number of times and I do not support it. That is my view, but it does not mean I am right. Neither does it mean I believe my view is any better or more strongly held than anybody else’s. Certainly, it is an ethical question.

Looking at the balances, ethically, I do not know where human life begins. My view is that it begins much earlier than fertilisation in many cases. One can bring it back to the dot, somewhere along the way, and all I have heard convinces me that I want research to continue into both adult and embryonic stem cells. I firmly believe we owe it to people who are suffering from debilitating degenerative diseases and I cannot find it in my heart to stop that from happening. I have listened very carefully to all the debate and I respect all the strongly held views.

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Nursing Home Standards
05/11/08 - The debate concerns an issue I have raised time and again in the past couple of years following the Leas Cross issue. I have had reservations from the beginning about setting up a new group of inspectors to check nursing homes. My view is that we should set and organise certain regulations and standards which are required for nursing homes and include them in the wider remit of other specialists.

I do not believe there is any one qualified person who can go into a nursing home and check all the things we would want to check. … I would like it to be included in the remit that, for example, local health inspectors would check the issues a health inspector would normally deal with in a restaurant, a pub or a general location; a fire officer would check issues to do with fire safety; a nursing specialist would check specifically the level of nursing standards; and similar would happen with regard to management, cleanliness, housekeeping, diet and so on…… This is a classic example of the kind of issue the Senators raised yesterday with regard to how we can save money in the public sector. …. No one person can check all the areas to which I referred unless he or she spends 25 years qualifying to do so.

This is a management issue. We need to organise the management of nursing home inspection in a way that employs the expertise already available, namely, specialists such as fire officers, health and safety inspectors, pharmacists, nursing inspectors and a variety of other groups.

We all reacted to what happened in Leas Cross and other places, which is understandable. However, it is not that simple. We need to consider this in a careful way to ascertain what gives the best value for money, effectiveness and efficiency.

Certain issues such as entertainment for and motivation of nursing home residents are important. I have occasion to visit nursing homes on a regular basis and I often see residents sitting around in a circle. However, at another nursing home I visit I have been impressed that its residents are entertained with singing and can avail of visiting services such as a hairdresser. In my experience most people who have a family member in a nursing home are happy with the level of care and support being given.

Another issue is that many people believe brand new nursing homes have the best standards. In my experience, however, some of the older nursing homes give a far more personal and acceptable service. It all comes down to caring and having caring people working in a nursing home. Those caring people do not have to be Irish either. It all comes down to looking at how best to deal with people.

Mistakes have been made in other areas concerning inspection when cadres of inspectors were promised but not enough were appointed. I do not want nursing homes to be out there as independent satellites, as it were. I want them part and parcel of an operational system which will be dealt with like other aspects of the service industry. While it is an area that touches many of our loved ones, the Minister of State must step back from any sentimentality and decide how to do this best.

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Medical Cards
05/11/08 - I was delighted to see the Government make the change. I do not have any problems with change of mind or U-turns because Governments are there to deal with issues and to find solutions. However, I disagree with the partial impact of the change. All the anecdotal evidence has been to the effect that the health of the over 70s has improved significantly since the introduction of universal entitlement to the medical card for that group of people. If for no other, this is a good reason to have introduced it and to maintain it.

The movement from gross to net income was unfortunate. I took serious issue with the line on the Department of Finance website on the morning the decision was made which stated it was being moved to gross income more or less because people understand their gross income more easily than their net income. This line, which is still on the website, is facile, flippant and irritating.

I have known the Minister long enough to know she would not deliberately misinform me or anybody else. However, I do not accept only 20,000 people are outside the limit. I have tried to put together figures in this regard and I have been able to judge the number of teachers who would not qualify. Between primary, post-primary and third level, I estimate that approximately 15,000 or about half of retired teachers would not qualify, although I stand to be corrected on this if the Minister can correct me. If I add to that the number of retired gardaí, nurses, civil servants and public servants who would be outside the limits, before even considering those in the private sector such as retired bank officials with occupational pensions, I cannot accept there are only 20,000 people. While I cannot disprove this at present, I intend to do so. I just do not believe it possibly could be correct that only 20,000 people over 70 are outside the limit. While I recognise that some of my figures apply to people in their 60s rather than their 70s, I do not believe the global figure.

The fundamental difference I have on this issue is that I disagree with the Minister’s point on medical cards. I am not in favour of giving medical cards to millionaires. I am in favour of universal access which should be paid for through proper taxation and other means. Rather than setting up a system of trying to measure who gets under the bar and all that goes with this system, the most honest way in a republic and a democracy is that everybody over 70 would have universal access. While I do not see them doing it, if Michael O’Leary and the lads want to queue up and apply for a medical card, they will get the same as everybody else. They pay their taxes and that is their entitlement.

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Mental Health Bill
30/10/08 - While I appreciate the need for this legislation, I am seriously uneasy about certain aspects of it. … I expressed concern about section 16 of the Mental Health Act 2001 in terms of the requirement to bring to the attention of the people concerned what exactly they were entitled to and what treatment they would receive.

We come then to the section of this Bill dealing with discretion. I did not follow the court case and was not aware of it until I heard about it today. I seriously doubt if the point of law is simply about the difference between a week, two weeks, five days or three days. I suspect the point of law is that the court will need to be confirmed in its view and will have to see evidence that the consultant exercised discretion. The only way in which the habeas corpus section of the Constitution could be reflected is by a consultant coming to a conclusion and exercising discretion. Discretion is always contemplated by that section of the Act.

I am not concerned about existing legislation and I understand there is a hole which we need to plug. I am concerned, however, about section 3 which states, “An unexpired order shall be deemed valid and always to have been valid”, “have been” being the past perfect tense. In other words, we are effectively saying that it might have been a breach of the habeas corpus section of the Constitution but that discretion need not have been exercised or that a consultant need not have made a defined, confined or succinct decision. I do not believe we can do that.We are trying to second guess the Constitution. I do not believe I have articulated the point clearly.

….. This is the same point I asked about before but I am still not clear on it. The constitutional position is that the law protects habeas corpus. The law required the consultant to exercise discretion. This section states “An unexpired renewal order shall be deemed to be valid and always to have been valid”. We are saying effectively that if the fail-safe which the law was required to put in to protect the habeas corpus section of the Constitution was not followed, this is okay. We do not have the power to do this and we are challenging the Constitution on that basis. I am not clear about it.

This is important. I grew up all my life knowing of cases of people being committed to psychiatric hospitals involuntarily with many outstanding questions. I can remember cases where it was said people were committed incorrectly. When this legislation was being put through, it was done to ensure such actions could not happen in the future.

It is very important legislation and although I do not argue with the actions of the Minister, can she say it “shall be deemed to be valid and always to have been valid”?

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Stem Cell Research
29/10/08- The governing body of UCC took a decision yesterday on stem cell research. I do not care whether Members criticise the university administrators but the harsh realty is we, as a Legislature, have funked making a decision on it. … We have not taken a decision, right or wrong, about it and we are the last ones who can start criticising those involved. I admire the decision taken but I do not know enough about it to discuss the rights and wrongs involved. The university was left in a vacuum with no guidance from the Legislature. The governing body consulted its own experts and took a decision on the basis of their response. That was the best we could have asked them to do until such time as we put legislation in place.

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Human Body Organs and Human Tissue Bill
01/10/08 - It is my privilege to second the Bill. .. I completely support what is proposed in the Bill. For many years, people have ticked the box on the back of their driving licences to indicate their willingness to donate their organs. I have argued on numerous occasions that we should do what Senator Quinn’s Bill proposes, that is, introduce the notion of presumed consent. The latter represents the way forward.

There are many levels between where we currently stand — with no legislation — to a position of presumed consent. If the Government is not prepared to go as far as Senator Quinn wants it to go in his Bill, which, in my opinion, represents the correct way to proceed, there is also the option of considering the notion of a required request. Where a person with healthy organs is fatally injured, there should be a requirement that his or her family should at least be requested to donate those organs. When a tragedy occurs and when a family is in the midst of grief, it does not cross the minds of its members that there is one small positive they can take from their bereavement. If they had been asked, many families would have been happy to accede to a request to donate their loved ones’ organs.

Senator Quinn and I are not proposing that someone’s next of kin should be pushed out of the way and that the relevant medical professionals should then harvest whatever viable organs remain. Those charged with harvesting organs go about their work in a sensitive, caring and understanding manner. They work in a way that draws the next of kin and those who are grieving into the process. I have met people who stated that they never got over the shock or grief of losing their son or daughter and that there is never a day on which they do not remember him or her, but that at least they receive a card from the transplant society or unit or from the parents of the person who benefited from the donation of their son’s or daughter’s organs, thanking them once more. Each year they are reminded that there are people with their son’s kidney, eye or otherwise. There is some element of consolation there.Of course, it is poor consolation for the loss of life but at least there is a feeling that they, or their dead child, has given something to society which lives on in a positive way.

It is important the Minister of State speaks in positive terms in his contribution. I would also like to hear him speak about the importance of a public awareness campaign. The Department is doing an audit of the harvesting, transplantations and donations taking place in Ireland currently. … it is important that this debate receives some recognition in the Department and that there is increased public awareness and education on the importance of a community.

Let us not leave the vacuum which currently exists and which should not be there. We need to legislate for this issue. The legislation is important not only for the reasons outlined by Senator Quinn but to show that this society cares about these issues, will legislate and deal with them and considers them important in our community. As long as we leave the vacuum, the finger can be pointed at us and people can ask what legislators are doing about it. I was not aware of the fact that Malta is the only other country in the EU which does not have legislation in this area. That is a sign for us to act quickly.

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Cancer Services
02/07/08 - In my 21 years in Leinster House I have never learnt anything in political debates on the health area. Anything I learn about the health service I learn through talking to people working in the service or through listening to experts on the radio. … I wish to place on the record of the House that I feel the Minister is doing a job above and beyond what might be expected of her. That may be an unusual comment to make in these Houses in these times. However, that is my view on the matter. She has taken on an almost impossible task and I feel a huge sense of sympathy in how to get it done.

One of the biggest problems people like me have in trying to take a middle line on the matter is that we have nothing by which to measure it. At the beginning of a year I would like to have a very clear understanding of the objectives for the year, the key performance indicators and how we would assess them at the end of the year. That would allow me to say this was the objective we set out to achieve and this is how far we got in areas such as waiting lists, the number of operations performed, diagnoses or whatever. That is the information I need. …. Given that we are talking about the running of a business with a management structure, I should be able to ask for the risk register for that particular institution, wherever it may be. …. I would like the risk registers of hospitals to be available. There is no reason for them not to be public documents and readily accessible. Over the course of the year the assessment of those documents should also be available.

Intuitively like everyone in the House, I find it difficult to live with the fact that there is no centre of excellence in the northern half of the country. The Fine Gael motion accepts much of what already exists and seeks something which should not be beyond practical response. On the issues of travel and quality and how they relate to each other, there is no contest. It would be an abrogation of the Minister’s responsibility were she to agree to establish a centre of excellence in a place where the scale, experience or amount of work being done did not reach the threshold to ensure quality.

Is the same level of scale needed in the four areas of diagnoses, surgery, chemotherapy and radiotherapy to make every centre of excellence effective? Could the surgery be in Galway and the treatment in Castlebar, for example? If we are moving, is it required to move everything?

The Fine Gael motion refers to “the proposed closures at University College Hospital Galway, where the Centre of Excellence is to be located, for the month of August this year due to severe budgetary constraints”, which is utterly unacceptable. I cannot find any justification for establishing a centre of excellence and closing it down in August. The Minister has spoken previously about the comfort of people who need to travel long distances. There is no point in dealing with it in a way that politicians then complain about how much it cost us to send people in taxis in the previous year. I have no difficulty sending people in taxis during a year if they are sick and need that kind of cover, we can justify the expense and it is done on a properly tendered basis. I saw the Minister writing when I first mentioned benchmarks and I will finish by saying it again. What people like me need are the benchmarks to assess progress so at the end of a year we can say whether we have made progress towards the key performance indicators and quantify it. That would be very helpful.

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Alcohol Advertising (Broadcasting Bill 2008)
25/06/08 - The issue here concerns broadcasting and the advertising of alcohol which is of real concern. I oppose censorship whenever I see it. I have found myself in a situation here, however, where I can see the other side of this matter. Sporting organisations deal with this matter on a regular basis. I declare an interest here as I am involved in the management committee and am a director of the GAA. It is fair to say that my colleagues at senior level in the GAA feel that broadcasting of drink advertising should not be allowed and should not be associated with sporting activities. As long as it is permitted, however, people cannot walk away from it because if they do they are turning away from necessary sponsorship money. This is a classic example of an issue on which the Oireachtas must regulate. It is similar to the introduction of employment equality in 1977. The playing pitch must be levelled and the only way to do that is to take on board these matters. Other European countries have done this.

What I propose here is a regulation banning such advertising before 9.00 p.m. Surely it is not unreasonable to ask that there would be no broadcast promotion of alcoholic beverages before that time. Amendment No. 35, in the name of Senator Norris and myself, goes a little beyond that and attaches a fine. … the manner in which society controls and presents alcohol consumption must be considered. Having reached a certain level of maturity, it would be appropriate for us to ban the advertising of alcohol before 9 p.m., or ban it altogether.

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Stem Cell Research
20/05/08 - We have touched on three or four occasions on the issue of stem cell research. Our colleagues across the water and in other European countries are grappling with this issue. We are afraid to deal with it because we may not like the outcome. I may have different views from others on the matter. This is another issue on which we should lead the public debate. We should let people hear both sides of the argument and inform society.

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ALCOHOL – Drink Driving Limit
24/04/08 - We need to discuss the matter of the report on alcohol sales. I would like to hear more about two issues related to it. One is the proposal to reduce the duty on drinks containing lower levels of alcohol, such as beers with an alcohol content of 3%. The other issue on which we need to hear more is the impact of reducing the drink driving limit from a blood-alcohol level of 80 milligrams to 50 milligrams. Are there statistics to prove that reducing the limit from 80 milligrams to 50 milligrams would make a significant impact on reducing the number of road deaths or injuries suffered in road traffic accidents? I have not seen those figures. I have asked for them previously.

I understand this is a political issue. I do not want us to rush into a political decision that will cause further chaos in rural Ireland unless we have to. If we have to do it, then we should, but we should have the figures. Usually when figures are produced on the number of people involved in accidents involving drink driving, the blood-alcohol level of those involved is much higher than 80 milligrams. The effort, money and time being put into reducing the level from 80 milligrams to 50 milligrams might result in the saving of many more lives if it was put into BreastCheck or increasing the availability of other cancer diagnostic elements throughout the country.

I would like to have a full, honest and balanced debate on this issue. If we have to reduce the drink driving limit, I will support it, but I want to see the figures to back up the case for doing so.

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Portlaoise Hospital Report
06/03/08 - Looking at it (the Portlaoise report) from a disinterested point of view in terms of trying to take the patient and emotion out of it, extraordinary questions must be asked on both sides of the House about the process. This is not a matter solely for the Opposition benches. I do not want to make this into a political issue. However, I want to know how the risk register was applied to Portlaoise hospital. What was supposed to be happening there and what was not? What were the key performance indicators required for that area? I want to know if people’s bonuses was tied into it. Were there mid-year reviews? How could it happen that people were using out-of-date equipment? Management must take responsibility for that. Someone in management was aware and decided to use out-of-date equipment. We need to know why and who these people are.

I am interested in the Portlaoise case not because it has been dealt with badly but because I want to know about the rest of the system and how it is run. Can we have a discussion on how the health system is run, without referring to any particular hospital, as if we were a board of directors getting a clear description of how it does its business?

In any small operation in the public service — I am involved in several semi-State bodies — at every board meeting there is an outline of which checks and balances were applied every quarter. An outside auditor is brought in to verify the system. Fail-safe measures in the system are tested to check if they are sufficiently robust and flexible.

These are expected in ordinary operations but it does not seem to be happening in the health service. I am not having a go at the Government or advisers. I just want to know what they are doing. The recent higher remuneration report assessed a particular management group in the Health Service Executive and admitted it did not know what they were doing. That cannot be in anyone’s interests. I want a debate on this to ensure moneys are spent properly.

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Emergency Contraception
27/02/08 - In the past 24 hours, there has been a certain amount of debate on the question of access to emergency contraception, also known as the morning after pill. We need to have a proper discussion on that issue to develop a clear understanding of what is available. As far back as 2001, the British Medical Association recommended that the morning after pill be made freely available in pharmacies. That is not the case in Ireland, where people have to get a doctor’s prescription. That requirement appears to be unnecessary and the only reason for it is to avoid encouraging too much sexual activity. Other jurisdictions have addressed the issue by requiring that people of a certain age have to go through, for example, a school nurse to access the pill. Research on the issue by Imperial College London concludes that access to the morning after pill does not impact in any way on sexual activity. It is progressive and safe to allow access and I would like an open debate on the issue with either the Minister for Justice, Equality and Law Reform or the Minister for Health and Children in the interest of making the pill available to people who need it.

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HSE
26/02/08 - I have not been in the habit of making complaints about the HSE because plenty of other people have been doing so. I am interested, however, in the way it does its business and two issues concerning the HSE that arose in the past week are of serious concern to me as a public representative.
In one case, the HSE has pulled its advertising from a radio station which had the cheek and audacity to follow it up on issues where the station felt the HSE was not giving a proper service. Rightly or wrongly, a radio station which has been following up on issues with the HSE, which is what the media is there to do, has had advertising pulled. I would like to hear someone explain that to me as there is something fundamentally undemocratic and wrong about it. I have very little sympathy for the HSE if it is not prepared to take punches and fight back.
Deputy Joe Costello has had a weekly demonstration outside the accident and emergency department of the Mater Hospital for the past four and half or five years to bring attention to certain aspects of the department he feels should be highlighted. He also takes the opportunity each week to speak to patients there. This is a praiseworthy action. It is praiseworthy for an elected public representative to see how the public service gives its service at a local level and is seen to do so. It is good for politics. He has now been told he is not wanted there anymore and that he should not be there. These two issues cause concern for me because of political accountability, what we intended the HSE to do and our relationship with the executive.

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Health (Miscellaneous Provisions) Bill 2007
19/12/07 - I do not know whether I should support or oppose this Bill, and when in doubt, “Vote No” quickly comes to mind.

There are two aspects of the Minister’s speech which seriously concern me. The first is her statement that there are technical drafting issues identified regarding the Medical Practitioners Act 2007. I would like to know how that came to be. ….. The Minister suggests we could be in breach of Article 15.2 of the Constitution, which gives the right to legislate to the Oireachtas. How did this happen? Senator Fitzgerald said that she would like to see the Attorney General’s advice. I would too, but I know there is not the remotest chance of seeing it.

Let me give the Minister the other side of the argument. I do not trust lawyers in this regard. I do not trust lawyers who tell me that we cannot do something by secondary legislation or by regulation. Neither do I trust them when they say we should not have done something by secondary legislation. I have been dealing with legislation for 20 years and like to put my hands in the wounds myself. It is right for the Minister to do what she is trying to do to ensure that matters are brought beyond doubt. She knows that and has the information to come to that conclusion, but I do not.

When I say I do not trust lawyers, I am not being dismissive of the profession. I feel they are used to taking one side or the other and are not much good in the middle. I would like to hear what the advice was, to hear the opposing argument and to come to a conclusion. We are entitled to that in this situation.

I know the hardest thing for a Minister for Health to do. I remember saying to one of the Minister’s predecessors, Deputy Michael Noonan, whom I defended in the House previously, that he should not have taken legal advice in the Mrs. McCole case. This situation is not parallel, but that was a good example of where a politician should strenuously overrule legal advice when not convinced it is necessary.

The Minister has spent as much of her life as I have of mine looking at legal advice and being prepared to throw it in the bin if it seemed incorrect or did not fit the need at the particular time. I am not sure this is not one of those cases. The distinction between secondary legislation such as regulation, statutory instrument, order or whatever is sometimes very fine. If it goes over the line, I like to know why. If it went over the line, somebody in the Department, it is probable that whoever drew up the statutory instrument, not the Attorney General, went beyond his or her authority.

I do not envy the Minister her job. My comments are heartfelt from the perspective of a legislator, but there are issues here that cause grave discomfort to anybody who worries about the process of legislation and regulation and their relationship with the Constitution.


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Motion of No Confidence in Minister for Health
28/11/07 - Perhaps it is the trade unionist in me but I tend to react strongly when I hear calls for people to be sacked. I examine matters such as due process and I regret that we cannot have another debate on it. I would not support a motion of no confidence in the Minister for Health and Children, Deputy Harney. It does not achieve anything and brings us back to what has happened in the House for 20 years. This does not deal with accountability, responsibility and the difference between the two. People do not know who should be held responsible. It is like saying there is a teacher in the west abusing children so we should sack the Minister for Education and Science. That is the level of logic prevailing.

I believe in holding the Minister to account and disagree fundamentally with many of her views. I will continue to debate them. There must be proper due process and a clear understanding of accountability so that when there is a change of Government, the next Minister with responsibility for health, if he or she comes from this side of the House, will not have to put up with the same attitude from the Members who are then in Opposition. It happens all the time. There must be accountability and responsibility and the difference between the two should be understood.

If I could see the risk register for Portlaoise Hospital and the risk register at various levels of the health service I could find out who needs to be brought to book in 20 minutes. If the Minister has not set up structures it is her fault. If she has, and other people are not operating them correctly as seems to be the case, it is the fault of others. If it is not the person at the top, and it need not be, we must find out where are the problems and single this area out for action.

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Pharmacist Negotiations and Pricing
22/11/07 - I support the Minister for Health and Children on the pharmacists matter. While I understand and approve of what the Minister is attempting to achieve, I do not understand what the row is about. The Irish Pharmaceutical Union is not entitled to represent its members to discuss dispensing costs with the Health Service Executive because it would be in breach of competition laws. As I see it, the Competition Authority will sit down with the HSE and the Minister for Health and Children, both of whom have a consumer interest and are required to give fair value. This would protect the consumer. If a discussion among a Department, a State body and the pharmaceutical union about getting the best price for consumers is in breach of the competition legislation then the legislation is an ass and should be changed quickly. If that is the case, the consumer is losing out. I am not putting the case for the pharmacists, as I share the Minister’s point of view on this issue.

I have discovered that pharmaceuticals are placed at different wholesale prices from country to country. This continues almost 50 years after we began to establish the so-called common market. The EU Commissioner responsible for the Internal Market, Mr. Charlie McCreevy should examine this issue. We are being hammered at least in part because of the high wholesale cost of pharmaceuticals based on a price determined by the pharmaceutical companies. I believe it breaches European legislation and it is certainly in breach of the Treaty of Rome. I would like us to consider whether the competition authority legislation protects the consumer and examine the European competition legislation which seems to go against the principles of the common market.

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Cancer Services - HSE
20/11/07 - I support what the Minister is doing in terms of centres of excellence and the cancer strategy, but I have many codicils. I became a Member in 1987 and, during my first week, I lunched with Barry Desmond, who had just finished his tenure as Minister for Health. He expressed his rage when discussing his problems in closing hospitals. …. I remember the Minister for Enterprise, Trade and Employment, Deputy Martin, being in deep trouble for the appalling nursing homes mess. …. I remember Deputy Noonan ten years ago, who I refer to because these people were at the centre of media demonisation. When Minister for Health, Deputy Noonan made a mistake in terms of the advice he received in respect of the Mrs. McCole case, but that did not take from my admiration for him as a Minister and what he was trying to do against all sorts of odds.

I have heard it all when it comes to people having a go at Ministers and it is occurring in the case of the current Minister, Deputy Harney. I admire her work, but I disagree fundamentally with some of her issues, which I will put on the record as I proceed. Let us begin with the role of Professor Drumm. I do not know Professor Drumm’s policy, but we passed legislation that requires him to take on board the Government’s policies and objectives. We demand that Professor Drumm be available to give an account of the general administration of the health services to an Oireachtas joint committee. I disagreed with this set-up then and I disagree with it still. Chief executives should be allowed have a view, say what they believe and drive policy as well as implement it.

I was delighted Senator Fitzgerald raised the issue of governance, accountability and responsibility. It is the height of nonsense to blame the Minister or the chief executive of the HSE when a hospital cannot be kept clean. Senator Fitzgerald is correct that there should be risk audits in hospitals to ensure they are kept clean. If they are not, someone in the hospital must be accountable and action should be taken.

It is unacceptable for a consultant who found dirty equipment at Portlaoise Hospital to claim the answer was to write a letter to the Minister. What do they do about dirty hypodermic needles? Do they write a letter about that? My view on this case is simple. They should have stopped using the equipment there and then and made someone deal with it.

Last week on radio, the Minister said she hoped to conclude the contract with the consultants by the end of the year, only for that to be contradicted an hour later by the consultants claiming that under no circumstances would it be finished by then. I want to hear more about this development.

I disagree fundamentally with the Minister, in principle and in practical terms, on bilocation. In practical terms, it is duplication. I believe consultants do a fabulous job and I am a great admirer of them. They are entitled to every penny they earn and I do not begrudge them a shilling of it. However, I want the world to know they earn their money using, at no charge to them, our hospitals, our beds, our nurses and our equipment. This is where I disagree with the Minister — I would make them pay for these services. Instead of building a second hospital on the one site, I would put a value on existing hospital services and let the consultants pay for them. I accept the Minister’s plausible argument that bilocation releases more beds. However, it must be recognised that consultants are using State equipment paid for with taxpayers’ money.

The levels of administrative staff in the health services is an issue constantly raised in the House. Not one Member wants to see consultants answering the telephone or scheduling their diaries, and there must a certain level of administration. The comments made by it (review body on higher remuneration) on extra people in senior management in the HSE are troubling. If the HSE could not come to a conclusion as to what some of its senior management are doing, it must be reviewed. In the change from the health boards to the HSE, there was a need to accommodate many people. Like what happened elsewhere, they either had to be bought out, paid off or given jobs. There is some element of duplication but that does not mean people should not be working.

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GAA and GPA - Players' Grants
14/11/07 - The matter of the GPA and GAA has been raised on a number of occasions in the past two weeks. I have hesitated to become involved in the matter and should declare an interest, in that I am part of the negotiating team dealing with the GPA on behalf of the GAA. The GAA and the GPA reached an agreement, of which I was part, and signed off on it more than one year ago. That agreement was brought to the Minister for Arts, Sports and Tourism prior to the election but it was not acceptable to his Department. We went back to the drawing board with the GPA and Dessie Farrell, myself and a few others hammered out another agreement which was signed off on. There is complete agreement on both sides and once again the agreement was brought to the Department of Arts, Sport and Tourism. To some extent, it was not acceptable to the Department.

There is no disagreement between the GPA and the GAA. They are in full agreement that this should be administered by the Sports Council. The Sports Council is a creature of Government and, therefore, it depends on Government to make it work. Any difficulties are minor. This merely needs political will and a decision at a high level to make it work. I believe the Minister, Deputy Brennan, is supportive of the idea but somebody needs to call the shots which is all that is required at this stage. That is the official position.

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Hospital Hygiene
13/11/07 - I wish to raise the hygiene issue. I would like to see a debate on that. I have a very different view on this matter than that of the Opposition in general. I am too long in the House to get sucked into blaming Ministers for everything that goes wrong and do not want to call for the resignation of a Minister or chief executive because staff cannot keep their hospitals clean. We should be clear that there are different levels of accountability and responsibility. Over the weekend, in the belief that we would be discussing the health service this week, I re-examined the Health Act 2004. I would recommend to Members to read what we all supported when it was enacted.

I object to one line in the Act pertaining to the appointment of a chief executive: “In carrying out duties under this section, the chief executive officer shall not question or express an opinion on the merits of any policy of the Government or a Minister . . .” For ten years, I have been saying the inclusion of this line in legislation is a disgrace. There is no point in politicians from either side of the House criticising a chief executive who does the Minister’s bidding if that chief executive is not allowed to contradict the Minister. The role of the chief executive is outlined in the Act and we therefore require clear thinking. Where there is a requirement to be responsible, let us demand that it is met, and where there is a requirement for accountability, let us demand it. Where hospitals are not being kept clean and where consultants are using dirty equipment and appeasing their consciences by writing a letter to the chief executive, I would expect a bit more. Let us have accountability at every level in the hospitals.

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Health Services and the HSE
08/11/07 - The House should discuss the health service. We should start by examining the legislation which established the Health Service Executive … to examine the question of accountability. We should also examine the issue of responsibility. It would make for a more serious debate if Senators knew who is responsible and who is accountable and what is the difference between responsibility and accountability. Unfortunately, as I have observed over the past 20 years, attitudes quickly change depending on which side of the House Senators sit. We must be able to understand the structure in place and identify who is responsible for what. As I indicated yesterday, the Health Service Executive was established because we did not want political interference in the health service. However, once political interference is removed, we are inclined to demand political responsibility. We cannot have it every way. We must decide what we want in this regard. Let us re-examine the legislation.

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Health Services and the HSE
07/11/07 - I am loath to get involved in a blame game, but we must examine the matter seriously. Benchmarks should be put in place in terms of what we expect from the health service and objectives for waiting lists, accident and emergency queues and cancer care should be set out during the next two years. People should be given one year to do what is expected before they reappear before the House to determine whether they have delivered. We should support or criticise them depending on whether things get done.

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Haemochromotosis
30/06/06 - A former Member of the House, Maurice Manning, recently published a report on behalf of the Irish Haemochromotosis Association which contained a series of recommendations on screening people for this condition, which is quite debilitating. I would welcome an opportunity to discuss this report and to hear the views of the Tánaiste and Minister for Health and Children on the implementation of the report’s recommendations. The group that compiled the report was, in fact, set up by the Tánaiste.

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Stem Cell Research
29/06/06 - A reasonable argument has been put forward on an issue. ……This is a matter of extraordinarily serious consequence and I accept that people hold different views. I suspect that views differ on both sides of the House. …. people should discuss it seriously and should consider all the views.

Members have seen the suffering that has come to families which cope with Alzheimer’s disease, Parkinson’s disease and a range of other issues. While I neither know nor purport to put forward the answers in this regard, apparently such conditions may be alleviated to some extent by stem cell research. I also understand that people have different views …. in respect of the difference between embryonic stem cells and adult cells. I am not familiar with the various arguments for and against such research.

However, this is absolutely crucial. ….. This is a major issue and while it sits in the ether, ordinary people will be led down the garden path. Perhaps they will go to quacks who do not know anything about it and purport to provide treatment which will not be effective at all. This issue must be regulated and co-ordinated.

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National Sports Campus Development Authority Bill
27/6/2006 - I must congratulate the Minister and his officials on the legislation, which I very much welcome. It is most important that this is focused on professionals, amateurs and the general public. If we are to get value from involvement in sport this legislation should bring about better quality of life and a greater appreciation and love of living which comes from sport. In terms of a centre of excellence, one of the problems is that we do not encourage sport early enough. If I was to take an oppositional line on this and recall what has happened in the past ten years, we have gone backwards, in terms of international success, although we are starting to come back again.

The biggest single influence on Irish sporting activity and achievement is the weather. We need all-weather access to sports facilities and we are very slow to recognise that. Senator Mansergh mentioned horse racing, for which there is a great love throughout Ireland. However, we do not have an all-weather racing track, although one is being built in Dundalk; the sooner it is completed, the better. One is not enough, however, for an industry that is so central to many aspects of Irish life and agri-industry, and we should have been on the ball much earlier.

I raised with the Minister before my belief that Ireland should be the European home of sailing. If counties were equipped with marinas, particularly along the west coast, it would bode well for that particular sport. This is an area that should be examined, getting people into the water, including the inland waterways. Fishing is an area in which there is continuing development. It is one of the mass sports in Ireland at the moment. I saw the figures involved recently and they were very high.

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OECD Report on Health Services
27/06/2006 - The report on the health service is really agitating people around the country. The Tánaiste and Minister for Health and Children, Deputy Harney, stated that this report was based on out of date information and the author of the report stated that the Department refused access to information. Somebody must answer for that. It is quite appalling. To the disinterested observer looking at this calmly and unemotionally, we cannot just accept that decision and we should know who took it.

The other issue to be noted from the report, apart from Ireland’s appalling results, is that the authors stated quite clearly that in their view the position of public and private sectors working together was the wrong way to go. That supports what the Tánaiste is trying to achieve and she should just go ahead and do it. Second, direct access to consultants was dealt with quite clearly in the report. If we are to use this report, let us use it positively and also ask the questions, move matters forward and get the results we seek.


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Public Hospital Lands and Consultants
31/05/06 - My opposition had been on the basis that something was to be given away to the private sector. I shared the view …..that this was completely unacceptable. Where does this leave me? I accept the point she (Tánaiste) clearly made to the House to the effect that not a square inch of public land will be given away and that any land to be used for private purposes will be sold or leased at the going rate. I appreciate that and it changes matters significantly.

That said, I still do not like this development. Having listened carefully to the arguments put forward by the Tánaiste, her position is logical. Nevertheless, I do not see why it must be on land which is available at present in hospitals. ……… the private sector should look after its own business. However, I do not object to private investment in the health services, if that is what people want. I object to taxpayers’ money subsidising it in any way.

I have been infuriated by the idea that up to the present, certain public beds owned by the State in public hospitals were under the control of private consultants. If I was obliged to make a choice between that practice and the Tánaiste’s proposals, I would prefer the latter. The idea that there is an empty bed in a hospital which the hospital authorities cannot assign to anyone because it is under the control of a consultant is one of the reasons why I believe the consultants’ contracts should be changed completely.

This measure should be fitted together with the renegotiation of the consultants’ contracts. Enough money should be paid to new consultants to attract the best people possible into the public health service. If only one of these measures is adopted, Members will be supporting the introduction of a two-tier system.

However, I have seen such a system work in other countries where the consultants in public hospitals were being paid at a rate that attracted the very best people who wanted to stay in well-paid secure employment where they could give a good service. The amount of money offered is insufficient to allow this to happen. We should move all those on existing consultant contracts to the private sector, where they can grow old, doing that business. Let us attract new energetic enthusiastic and ambitious consultants into the public health service and give us back the beds we own.

If public lands are given away to private interests I strongly support the point made by Opposition parties. It is our duty to ensure this does not happen. However, the suggestion that this is a cost effective manner of releasing or producing an additional 1,000 beds in the public sector is an attractive proposition. It will only work if it is matched by consultants of quality.


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Accident and Emergency Services
09/05/06 - I listened to the debate since it began and it is like every other debate I have heard on this issue, in that it is a constant rehearsal of the problems with few solutions offered. I will probably do more of the same. In my view, the Tánaiste is as committed to this as anybody has ever been. Whatever the problems are, they certainly have not been resolved. Simply politicising them does not help our case.

We could and should do certain things which we have not done. The consultants’ contract has not been dealt with. My view is that the Tánaiste has not offered enough money. I stated before that I would offer them more than €300,000 to be available, to work the appropriate number of shifts and to make progress. I would tell the consultants we would protect their contract for as long as they wanted to keep it. I am certain we can afford to pay that amount of money to consultants. Even though it would be less than what they may earn in the private sector, by the time the cost of running an office is removed and the importance of a pension is added, it becomes an extremely attractive proposal.

I would resolve those issues by taking decisions and progressing in a way that protects the consultants. We must recognise they are under an agreed contract. The only way to deal with it in HR terms is to recognise, acknowledge and respect that contract and allow the consultants to have it for as long as they wish. We must negotiate a new contract for new people. Decisions must be made on that basis.

What discussion has taken place with the unions and the organisation representing all of the other groups working in those services? My understanding, and I may be wrong because it is based on anecdote rather than on official information, is that no real negotiations or discussions have taken place on how to do this. Until we can operate a system where all of our assets are operational and available for at least two shifts a day we will never deal with the issue. That must be done.

The Tánaiste is correct when she states it is not only about money. At the same time, she should qualify that by stating more funding is required. We must set about getting value for money and the service required.
On a number of occasions, the Tánaiste raised the issue of GP clinics. That is an important part of the issue. I have no doubt that people do not of their own volition go to an accident and emergency department to queue for six, seven or eight hours in some cases. They do not do so lightly. In many of these cases people need some sort of reassurance that they, or a child or parent, are not actually dying. If they are examined there will be a certain reassurance. There would also need to be an assurance that any additional treatment required will be received.

My home town of Dingle, located on the west Kerry Peninsula, is in a difficult area. Somebody from Dunquin would have to drive more than 40 miles to the regional hospital in Tralee. That is a long and difficult drive. The GPs in the area recently put forward a plan to the HSE where they would provide 24-hour cover every day of the week. It needed the support of one additional person, which has not been given to the group. There may be good reasons for this, but to a person listening to the discussion, it seemed like a local initiative. I know some of the GPs involved and they would have very good reputations. They would not lightly put forward a proposal they felt would not work, and they felt they could provide a service. There is no doubt that this would immediately take pressure off the accident and emergency department in Tralee hospital.

When people arrive at an accident and emergency department for an X-ray, for example, why do these people have to queue up in one place and cause a blockage at the beginning, before having to go to another queue at X-ray? Why do these people not simply go straight into the X-ray section? Apparently that is not allowed, and these people have to go through each step, creating clogs in each of them. Such issues are not being thought out at that level. I will not get involved in the political arguments of the drink issue, but as far as I understand, drunk tanks should be in police stations. They have nothing to do with hospitals.

Those are the kinds of issues we should examine. We must resolve the problems in order to ensure we get the support and structures required to make the services work. It is not a purely political issue. Money and change is required, as is direction and commitment.

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Recommendations of Lourdes Hospital Report
04/05/06 - We recently had a very moving debate on the report into the activities of Dr. Neary in Our Lady of Lourdes Hospital in Drogheda. We were appalled at the hardship, trauma and suffering imposed on those women who went to have their children in that hospital. We looked at the recommendations of the learned judge who produced the report and we asked for them to be implemented. It now transpires that the judge has made a return trip to the hospital to discover what kind of action has been taken on foot of the recommendations. We find, appallingly, that whereas the hospital has made a serious effort to implement what was required of it at hospital authority level and staff level within the hospital, the HSE has done nothing whatever to implement the recommendations of the report.

Considering that the report galvanised this country and shocked all of us, it is absolutely incredible that nothing would be done. The Tánaiste and Minister for Health and Children, Deputy Harney, would be within her rights to demand an explanation from the HSE as to why nothing has been done. I would welcome an opportunity to discuss with the Tánaiste how the recommendations of the report will be implemented and what action she proposes to take, or can take, to ensure they will be implemented.

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Screening for Hearing Disabilities in Newborn Babies
06/04/06 - I wish to raise an issue which was in the news some weeks ago and which I have researched somewhat in the meantime, namely, the lack of screening for newborn babies for hearing disabilities. Currently we carry out what is called a distraction test to assess children’s hearing when they are about one year old. A nurse clicks his or her fingers and observes if a child reacts. All this identifies is children who are profoundly deaf.

There is a simple and cheap test that involves putting a probe in a day-old baby’s ear for a couple of seconds. This immediately picks up any difficulties which can be followed by a simple treatment of brain stimulation which ensures, for instance, that a child beginning school has almost full language capacity. This is a significant improvement and I ask that we would consider this option. This could avoid a significant amount of hardship on families. It is one of the few measures in the health area which is very inexpensive and it could be provided to every maternity hospital in the country for approximately €3 million or €4 million a year, which is peanuts in terms of the cost of the health budget. The returns would give new life to families and children to protect their children. It is not just a matter of the problem being identified but the treatment being provided to ensure that a child develops properly. The Tánaiste and Minister for Health and Children should come to the House to deal with this issue.

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Cancer Services
23/03/06 - We jump up and down here in outrage regularly on the basis of gun crime and people dying by the gun or as a result of road accidents, but there are more unnecessary deaths among women from cancer each year. There are twice, if not three times, as many deaths among women from cancer as the cumulative number of deaths resulting from gun crime and road accidents. The lives of at least 1,000 women a year could be saved and they could be alive if we were to ensure the roll-out of the cancer screening programme to all parts of rural and provincial Ireland. The current position is disgraceful. We are more agitated about avian flu and the possibility of an outbreak of SARS in China than we are about burying many of our own people unnecessarily year after year. We need to address that. The Minister for Health and Children should come to the House and it should be pointed out to her that this is an infrastructural issue which is hugely important. This issue is only one aspect of health care — there are many more. However, this is one aspect which, if addressed, could have an immediate impact and bring about positive results. I ask that we discuss this matter.

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Cancer Services
22/03/06 - We have spent considerable time in this Chamber discussing gun crimes and deaths, driving behaviour and road deaths, but if we take the example of any female cancer, such as breast cancer, more people die from this each year than from gun crimes and road traffic accidents combined. Why is there no outcry? Why is this happening when we have the answer? We have the knowledge and everything that is needed. All that must be done is to roll out the facilities to every county in the country, but this is not being done. It is extraordinary.

The facts contained in the latest report, Women and Cancer in Ireland 1994-2001 are startling. We are the country with the greatest economic story in the last ten or 15 years, that has made the most progress and been set up as a role model, but we still cannot care for our people in a simple and straightforward way. It is inexcusable.

We have easily moved from referring to dying of cancer to living with cancer. Anyone who knows someone with cancer knows that this change is real. People can have good quality of life seven or eight years after being diagnosed.

The introduction of mammogram screening is a measure we can afford. Why is this not a priority? It would have full support and immediate results. Politicians are blamed for not accomplishing things because important measures take a long time to make a difference. However, this measure would make an immediate difference. Inviting each woman in Ireland for breast, cervical and other cancer screening would immediately save lives, make an impact on the quality of life in the community and benefit families. There are no negative consequences to this. The worst cancers might be diagnosed too late to cure the person but the measure would extend the life of everybody diagnosed in that period.

Politicians may like to talk about matters where there is no clear solution but in this case the solution is absolutely clear. This is a cash investment with immediate returns, welcomed by everyone and supported by the community. I urge the Minister of State to apply pressure to make this happen. If it does not happen, we will face a revolution and we will never be thanked.

People become angry with frustration when they realise an early diagnosis could have allowed a loved one to live longer. The Minister of State must have met such people, as I have. Breast and cervical cancer screening must be made available to women in every county in Ireland. An information programme is of equal importance so that people know the diagnosis of cancer is not a death sentence. If the disease is diagnosed early it is not a death sentence in the majority of cases. The campaign should show the success rate that can be achieved if people are checked.

A breast and cervical screening programme must be fully implemented. We also need appropriate tests for those who are worried their genes may make them more susceptible to cancer. These tests are being done but it is too late in many cases. I also suggest we launch an education programme on diet, lifestyle, alcohol and smoking. This has been done to great effect with regard to smoking and the programme should show how these other aspects can also affect lives and how they can be controlled to save lives.

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Lourdes Hospital Enquiry
09/03/06 - I welcome the opportunity to contribute to the debate, although I am not sure I can add much to what has been said. I would like to consider the issues in a cold light because the women who suffered have been left behind by the system and we must take responsibility for that. While I can blame Dr. Neary, these women and the people of Ireland depend on public representatives to ensure regulations are in place and protocols, structures and processes are correct. However, they were not in this instance and that is the most shocking aspect.

This was not only a case of one guy getting it wrong. How did he ever come to be appointed to the Lourdes hospital, given that he did not meet the necessary criteria for the post? He should never have been employed by the hospital in the first place. I refer to the consultants who took him out to lunch before investigating him and who then came to a conclusion — surprise, surprise — that he had nothing to answer for. It is appalling that this should have been allowed to happen. I do not understand how people brought in to run the rule over the man would do so in this manner by creating a “palsy-walsy” ambience at lunch and conducting an examination afterwards. That should not have happened. No matter what conclusion they reached, one would have had to question the impartiality of the investigation. I do not know whether the investigating consultants are answerable. Has their work been checked?

The question of normality arises. What is the norm? This practice was the norm for the Drogheda hospital and, therefore, none of the staff knew the difference. The crudeness and insensitivity of this man’s language and approach to his patients was appalling. We often hear about the lack of manners on the part of consultants and their overbearing attitude and superiority when dealing with patients, but this man’s behaviour brought that to a new level.

There is a question as to whether religious philosophies or beliefs had a bearing on events. I believe they did, but I do not know why this man did what he did. Despite having read through the report and tried to come to a conclusion, I cannot. I know what happened and that is enough for me. I do not need to know his motivation. It might make it worse and certainly would not make it any better. I cannot think of any benign philosophical basis on which he might have done this that could make me feel it is not as bad as it looks. It is as bad as it looks.

Doctor Neary’s apology is not worth seeking. I do not want to hear it as it is worth nothing and would only give him some dignity. My rule is never to seek an apology. I would only feel an apology was worthwhile if I had come to a good judgment about the person offering it. If it was somebody about whose judgment I did not care, I would not care for his or her apology. That is the case in this situation.

The area of compensation is sensitive. I do not know how we can calculate compensation. I am the vice-chairman of the Personal Injuries Assessment Board where we examine this sort of issue on a regular basis. However, I would not know where to start in terms of the traumatic impact on these women, not just psychological and physical, but in terms of relationships, self confidence and assertiveness as I feel these women have to rebuild their lives. I hope our discussion in the Oireachtas and the media will help them see that people are trying to understand their trauma and to be supportive. If we can offer nothing else, we can offer that.

With regard to compensation, we need to make early assessments and to deliver on them. I know this is not a payment and that “compensation” is probably the wrong word to use. It is an offering we need to make to these women. I would be appalled if along the way we come to a point where we have to ask could we not have done better by them. We should do what we think is right and do it in spades. An approach should then be made to the insurance companies. However, let us not wait.

If we look into the issue and see where people find themselves, we see that this has been an appalling, embarrassing chapter in Irish medical history and political life. We should bow our heads in shame and give our apology to these women.

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Medical Council
23/02/06 - For a number of years we have dealt with the issue of the mutual recognition of qualifications in European countries. The Medical Council is experiencing extraordinary difficulty with regard to doctors who are struck off the register and not allowed to practice in other jurisdictions but who must be accepted and recognised by the Medical Council if they come to Ireland. That seems to turn the whole idea of the mutual recognition of qualifications on its head. At a time when foreign teachers, pharmacists and veterinary practitioners cannot be recognised here due to qualification problems, the idea that a doctor from another European jurisdiction who had been struck off cannot be rejected by the Medical Council is appalling, in particular given that the Medical Council is doing all it can to expand its role as a supervisory authority of the medical profession in terms of visiting GPs and so on. We should discuss this issue, show support for the Medical Council and ask the Minister to introduce the appropriate legislation.


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