I have listened to Deputy Higgins make similar allegations for a number of months and my colleague, the Minister for Education, has answered them on each occasion. I have no doubt that she will come into this House within the next two days and again answer the kind of allegations that have been made here today.


I wish to speak in this confidence motion about the immediate problems giving rise to the motion and about the Government's outstanding record including the record of my Department and our achievements in the health area despite the difficult financial situation.


I, like most Members of this House, am concerned at recent developments in a very small number of companies, both private and State.
The truth needs to be established and the public informed. Wrongdoing must be dealt with and correct processes put in place where necessary. If there are loopholes, they must be closed. If there has been a slippage in standards, then standards must be reasserted. If there is wrongdoing, it must be appropriately dealt with.
If we look world wide other countries have their own problems. The world of finance is going through a troubled period. A period where the old rules are no longer effective. Japan, the United States and Britain have been rocked by scandals that did not involve a few million pounds, but hundreds of billions of pounds. Fortunately we have few such problems in Ireland and consequently they are all the more shocking when they occur.
There is no place for any financial misbehaviour in our society. It must be rooted out. However, the manner in which these issues are pursued is critical to the national interest. As Members of the Oireachtas there is an obligation on [523] us to do this not just effectively but responsibly.
National interest demands that all the issues raised and allegations made be dealt with in a proper, fair, just and logical manner. The manner in which these issues are pursued is critical to the national interest. There are allegations being thrown around as if they were proven fact and that is certainly not in anybody's interest.
While the wrongdoing of a few must be dealt with, it is important to ensure that confidence is maintained in the overwhelming majority of upright businesses that we have in this country. As politicians we have a responsibility to ensure that we do not damage our people, our country or our image internationally. I am afraid from the behaviour of the Opposition parties at present that this is not very high on their agenda.
The portrayal of events by the Opposition has created great unease for all the wrong reasons, for short term political gain.
The Government reacted promptly by using the full power of the courts by ensuring thorough investigations, for example, the Tribunal of Inquiry into the Beef Industry, the Department of Tourism, Transport and Communications Telecom inquiry and the Siicre ireann and associated companies inquiry. I am satisfied with the nature of these inquiries. I know that the Government will take whatever action necessary following these investigations. The Dil can question the methods of investigation and whether they can be improved.
However, it is not in anyone's interest and certainly not in the national interest that individuals and companies should be tried by innuendo, convicted and sentenced before these reports are available. The Government will take any action necessary when they receive the reports.
I welcome constructive criticism. The Opposition have their role and that is part and parcel of our democratic system. However if you look at the Opposition at the moment you wonder where the [524] national interest ends and policial opportunism takes over. This highlights a fundamental difference between Fianna Fil and the present Opposition parties. Compare the Opposition's behaviour today with that of Fianna Fil in opposition in 1982-87. We can all recall what happened during that period in Irish Shipping and ICI. ICI was the greatest business scandal of the past ten years, If the Opposition of that time behaved in the same way as the Opposition are behaving today they would have caused the collapse of a major bank involved at the time. Look at the facts in 1985. Fine Gael and Labour were in Government when the ICI scandal occurred. Look at how Fianna Fil in opposition behaved compared with the parties in opposition today. The situation was so serious then that emergency legislation was necessary. The then Minister for Industry, Trade, Commerce and Tourism, Deputy John Bruton, now Leader of Fine Gael, introduced the Bill and left many questions unanswered. Let us look at how the Opposition behaved at that time. Speaking on the legislation, as reported at column 708 of the Official Report for 27 March 1985, Deputy Haughey, Leader of the then Opposition said:
As the principal Opposition party, we immediately took a definite, responsible attitude and indicated that as the Government had said they were acting in the national interest we would, in order to avoid a crisis of conscience, make it clear that we would take the Government at their word and offer whatever parliamentary support was necessary to overcome the difficulty and protect the financial institutions of the State and the country's creditworthiness.
Deputy Haughey continued:
It is important that the world at large should see whatever else can be said about politics in this country the Oireachtas was prepared, where necessary, to give any support needed when the Government could indicate that [525] it was taking action in the national interest.

Could anybody say one word in favour of the way the Opposition today have behaved when the Government faced up to their responsibility on these problems?
Deputy John Bruton, the then Minister for Industry Trade, Commerce and Tourism responded as reported at column 1124 of the Official Report for 28 March 1985:
However, it must be accepted that there was an endeavour by all sides to find a solution and this is true of the Opposition and the Leader of the Opposition who is present. All tried to find a solution and to contribute to the best of their knowledge, ability and experience. Although this debate was occasioned by a very regrettable and sad event it was useful in helping to formulate policy.
Will the Taoiseach of the day be able to say that the Opposition gave any assistance in dealing with situations in the business world which were totally outside the control of the Government and, as the Taoiseach has pointed out, no politicians were involved.

Fianna Fil in Opposition could be as tough as the best of them in adversarial debate. When the national interest demanded it we always rose to the occasion. We took a responsible position as I have stated under our present Taoiseach, Deputy Charles Haughey, then Leader of the Opposition. That is not the situation today with the Opposition parties and in my view is one of the reasons they have spent so much time in opposition since 1932.
They have demonstrated over the past two years that they have no alternative policies whatsoever and perhaps they believe that rhetoric and irresponsible [526] behaviour will hide these facts from the public. Not alone are they irresponsible in opposition but the Fine Gael and Labour Parties were irresponsible when in Government. I dealt at length before with their behaviour in the area of the health services and when they allowed health boards to overspend 55 million which they never provided. That was something that caused major problems for us when we came into Government.
Before going on to deal with my own particular area of responsibility where enormous progress has been made despite our financial difficulties, I want to refer to the overall record of Fianna Fil since we took office in 1987. At that time the public finances were out of control, growth in the economy was non existent, the national debt had reached crippling proportions and confidence in the economy was at its lowest ever.
We now have, because of the action taken by the Government, a sound economic base for our future development. The public finances have been brought under control. It is true that we have a short term problem in relation to 1992 but this problem will be tackled by the Government in the same determined way we approached the crisis situation we inherited. The underlying economic position is very strong as a result of the action that has been taken since 1987.
Economic growth has returned and has been sustained. We have low inflation and a favourable balance of payments and a stable exchange rate ensuring a major improvement in our competitive position. We are well placed to benefit from the upswing in economic activity already forecast worldwide.
It is no harm to remind this House of the major part played by the Programme for National Recovery in turning our economy around. The programme was negotiated in 1987 and it brought the unions, the employers and the farmers together to forge a consensus to save the country from bankruptcy. We are all aware of the major personal part played by the Taoiseach himself in achieving that agreement and in dealing with the very [527] serious problems confronting the country.
We all acknowledge the serious unemployment situation in the country today. Sadly, that is not a problem unique to Ireland. The general global recession is affecting us here, as is the return of many emigrants who cannot get jobs abroad. The economic growth forecast worldwide will no doubt cause this situation here to improve.
An indication of this was announced only yesterday, with the Director General of the CII reporting that manufacturing industry was showing recent improvement in exports and output. Against fierce competition, we have also succeeded in attracting major high technology investment into this country.
Since 1987 major improvements have been made in tax reliefs and reforms. Income tax rates have come down. VAT has come down. Income tax relief exemption limits were raised to help the people on low pay. We have succeeded in keeping ahead of inflation with social welfare payments. Each year we have given special increases to raise the real standards of living for people who are long term unemployed.
I am very glad to have this opportunity of placing the Government's record in developing our heath services before the House today. It is a record of solid achievement based on carefuly thought out strategies to build on the strengths of the existing system.
Looking directly at health, I believe that the progress we have made in the health area over the past few years is an indication of the Government's determination to establish a proper course of action and to stay with it. We have achieved this despite the severe constraints facing the public finances generally. We have made important progress and have taken a number of key decisions on eligibility and organisational structures this year which will have a very positive impact in the future.
Prior to 1987 there was no cohesive approach to developing our health system in accordance with recognised [528] needs or to addressing its problems. The Government have set about a consistent, rational process of identifying service needs, examining how best they can be met in the most cost-effective way and planning for their structured implementation.
We have paid particular attention to the need for medium to long term planning. The restructuring and reorientation of our health system has, of course, been difficult but we have pressed ahead with devising and implementing a streamlined health service which is capable of responding to the enormous demands placed upon it.
I would like to remind Deputies of the practical steps taken by the Government and of the tangible progress made in the past few years. In 1987 I established the Commission on Health Funding, a broadly based body representative of a wide range of interests and expertise in the health services, to advise me on the direction that health policy should take. The Commission reported in late 1989 and provided the first comprehensive analysis of the entire health system since the White Paper of 1966.
The Commission made recommendations on all of the key issues in health policy, including the approach to funding, eligibility, administrative structures and individual service areas. Its report now forms the basis of a number of important decisions that have been taken by the Government since then.
The Commission's work has proved invaluable in pointing the overall direction our health service should take. However, I also established a number of other expert groups to advise on individual aspects of the health services, given the complexity and technical nature of many of the issues to be considered. These bodies included the Dublin Hospital Initiative Group chaired by Professor David Kennedy, whose series of splendid reports I launched last month, and the Hospital Efficiency Review Group under Noel Fox.
We have been criticised frequently for establishing these working parties and other advisory bodies in the health area. [529] I think this is ironic, given that the reports to which I referred are now providing the foundation of the process of improving the quality and efficiency of our health services.
Let me remind Deputies of the progress made in implementing the report of the Commission on Health Funding.
Earlier this year we streamlined the system of eligibility for health services, in accordance with the Commission's recommendations. Prior to 1 June this year we had a three category system which was acknowledged as being unfair in its assessment of income and as giving rise to potentially serious anomalies in the assessment of eligibility for hospital services.
The Government therefore accepted the Commission's recommendation that Category III be abolished, and the Oireachtas approved the necessary legislation earlier this year. This decision was also supported by the social partners under the Programme for Economic and Social Progress. Its positive effects will become obvious over time, particularly since we have combined it with a fair system of access to public hospitals. Under this arrangement, which is being phased in at present, patients in non-emergency situations must opt explicitly for public or private care. The previous practice of combining public ward accommodation with private consultant care will no longer be permitted. This will ensure fairer access for all to public hospitals and will be of greater benefit to public patients.
One of the most important conclusions reached by the Commission on Health Funding, and echoed strongly by Professor Kennedy's group, was that we would have to address urgently the problems inherent in the administrative structure of our health system. These problems have built up over time and must be resolved quickly so that an adaptable, responsible service can be put in place.
Both the Commission and the Dublin Hospital Initiative Group pointed to the fragmentation of different services and to the lack of co-ordination between [530] hospital and community based services. I have been conscious that these difficulties have led to an over-involvement by my Department in the day-to-day management of services, at a time when policy-making on the future direction of services should be to the fore.
It was against this background that I announced the setting up of a new regional health authority to replace the Eastern Health Board. The new authority will have a more direct relationship with all of the health agencies in its area, thereby ensuring a greater co-ordination of hospital and community based services.
I should point out, however, that the legislation will have important national effects as well as those directed specifically towards the Eastern Health Board area. It will, for example, clarify the roles, relationships and accountability of health board members and their chief executive officers. It will also clarify the functions of the Minister for Health, the Department of Health and agencies involved in service delivery.
In this way, the legislation will make much clearer who should be doing what in the health system. My Department and I, as Minister, will be able to concentrate on the development of health policy and the overall control of expenditure, rather than becoming over-involved in the detailed day-to-day management of individual services. Operational management must be devolved to the appropriate health agencies if we are to achieve greater efficiency. I am confident that the new organisational arrangements in the Dublin, Kildare and Wicklow areas will have a very positive impact in this regard.
I should emphasise, as I did when announcing the Government's decisions on these matters, that there will be full consultation with all interested parties on the details of these decisions. Indeed, I have already invited agencies to make written submissions on the issues of concern to them, and I look forward to their responses before proceeding further with the preparation of the legislation.
[531] Since taking office the Government have been anxious to identify the most appropriate means of tackling any problems in each area of the health service. In the acute hospital sector Professor Kennedy's reports have proved invaluable. His group's interim report, published in June 1990 made a series of recommendations on the best practices and policies aimed at ensuring a quality service with the maximum of efficiency and effectiveness. Many of the hospitals involved in the study by Professor Kennedy's group have now implemented the recommendations on such areas as: admission and discharge policies, bed and patient management and the operation of Accident and Emergency Departments.
After completion of the other reports Professor Kennedy agreed to chair an advisory group which, together with my Department's officials, will oversee the implementation of the group's recommendations on improvement of hospital services. They will also help me to monitor and review progress over time. I am very pleased to say that Mr. Noel Fox, whose efficiency review of Dublin hospitals was of such value, has agreed to become a member of the Kennedy Advisory Group.
It will be clear to Deputies, therefore, that the Government have a carefully devised, well thought out approach to the improvement of our hospital system. It is based not simply on ploughing countless millions of pounds into the service in the hope that any problems will thereby be solved but instead draws on the recognised objective expertise of eminent professionals who have examined the acute hospital sector in detail and have made sensible, realistic recommendations which can now be implemented systematically. A key point of this process has been the development of the necessary consensus, without which wide-ranging changes cannot be implemented successfully.
This planned approach to service developments extends also to the community based services. Starting with the [532] Commission on Health Funding and drawing upon a range of expert reports on individual areas, the Government have a very clear view of the direction which these services should take in the coming years.
The Commission on Health Funding stressed the need for an analytical approach to identifying service needs, examining alternative options of meeting those needs and of monitoring the implementation process in the light of changing circumstances. I might stress that there is little to be gained from merely pumping moneys into particular services without regard to effectiveness or efficiency. The course which we have charted ensures that money is allocated only after careful assessment of need and of the best method of meeting those needs in each locality.
It is with this approach in mind that the Programme for Economic and Social Progress committed the Government to a planned expansion of designated community-based services, in accordance with the recommendations of the groups which reported on each area. This is an important element of the Government's policy on the future direction of the health services.
The Government have made significant progress in a number of areas of health legislation. I have referred already to the recent important improvements in the eligibility system introduced under the Health (Amendment) Act, 1991. We have also passed the Health (Nursing Homes) Act, 1990, which provided amongst other things, for a new system of registration under which all non-health board homes, whether run for profit or on a voluntary basis, will be obliged to operate. It also provides for a fairer approach to subventing nursing homes based on the merits of each individual applicant. This will replace the present unsatisfactory system which did not guarantee that the limited funds available were channelled towards the most appropriate applicants.
Then there is the Child Care Act, 1991. For some time past the Government have been extremely anxious to address a [533] range of legal issues in the area of child care. Therefore I was glad to see the Oireachtas enact the new Child Care Act 1991, before the summer recess. That Act imposes a statutory duty on health boards to promote the welfare of any child in the community not receiving adequate care and protection. It also gives the boards new powers to provide child care and family support services, introducing a new legal procedure enabling health boards and the Garda to intervene where children are being neglected or abused. The Act takes account of the many practical and cultural developments, such as the need for legal controls on pre-school services and a modernised statutory framework for the regulation of children's residential centres. The new Act updates the grounds on which children may be taken into care and introduces new provisions regarding legal representation to children involved in care proceedings. As in the case of other community-based services the Government have committed themselves to making the necessary resources available for implementation. Indeed that commitment is contained in the Programme for Economic and Social Progress.
The Adoption Act, 1991, recognising foreign adoptions, was passed by this House.
Other areas in which there has been progress in health services include a patients' charter. The Government have placed special emphasis on ensuring that not only the efficiency but also the quality of services to patients receive close attention. After all, the patient is the central focus of our services. Patients' needs must be to the forefront when planning our services. With that in mind the Programme for Economic and Social Progress reiterates the Government's commitment to introducing a patients' charter. In consultation with hospitals throughout the country we are making good progress in developing that charter which will be based on the fundamental principles of access to service in accordance with need, the right to privacy, to information and to confidentiality of all [534] medical records along with the right to make a complaint and have that complaint properly dealt with. The charter will also recognise the right to respect for religious and philosophical beliefs and the right to refuse to participate in research projects.
Closely allied to the patients' charter is the need for a formal statutory appeals system for medical cards for those whose applications have been rejected. I undertook some time ago to introduce such a system. I am finalising the preparations for putting this in place. Recently the relevant chief executive officers reviewed their methods of assessing eligibility for medical cards. Hopefully that will improve the system.
A common contract for hospital consultants has been introduced. It reflects the importance of hospital consultants to our hospitals system, providing them with an appropriate role in the management of hospitals. Given their influence over the allocation of resources it is important that the involvement of consultants in the management process be recognised and structured appropriately. I am happy that the revised contract will achieve this objective and that the functioning of hospitals will be the better for it.
The wide range of initiatives and concrete developments I have outlined to the House clearly demonstrates that the Government have acted consistently and firmly in relation to the health services. We have not depended on pumping money into the health system in the hope that problems will just go away. Instead we have examined problem areas methodically. I and my colleague, the Minister of State, have identified with the help of experts, what needs to be done and set about the implementation process with the same purpose of mind. An increasing amount of money is being provided each year, and we have discussed that matter here on other occasions. We will not be pushed into unwise, impulsive action merely to be seen to be doing something. We have a clear view of the direction our health services should take and will [535] continue to implement our approach with conviction.
The Government have an important job to do keeping the finances in order, continuing to maintain and develop the environment for further job creation, in addition to playing an important role in the building of the new Europe.
I believe the House should vote confidence in this Government and let them get on with the job.

