Patient is lost in system - Mitchell

The Fine Gael spokeswoman on health, Ms Olivia Mitchell, said her party intended opposing the Bill to abolish health boards.

Ms Mitchell said that it abolished a framework of accountability within the system without any idea of what would replace it. "This is a leap of faith which Fine Gael is not willing to make."

She added that the Minister for Health, Mr Martin, had assured the House that there would be accountability because he was accountable to the Dáil. "Even if that were to happen, and it is not clear that it will, there can only ever be limited accountability."

Ms Mitchell said she accepted that the health service had outgrown the current structures and that they were designed for a different time and population.

"Over the years, by an accretion of functions and services, the structure has become unwieldy and fragmented."

The patient, she added, was now largely lost in the current system.

"Will the patient ever be found in the new one? Perhaps, but I am not convinced that streamlining and centralising the services as proposed is necessarily consistent with better patient care or greater efficiency.

"My concern is that, if it is not consistent, there is no one to speak for patients, call a halt and ask hard questions or any questions."

The Labour spokeswoman on health, Ms Liz McManus, said the fundamental flaw in the Bill was that it removed democratic involvement in local health services without proposing any equivalent new system of accountability.

"As such, it is a disturbing and unwelcome change that augurs badly for the future. Members across the House are agreed that there is a need for reform of health boards, but reform is not being proposed in the Bill," she said.

Earlier, introducing the Health (Amendment) Bill, Mr Martin said that one of the central findings of the review of the system was that there were too many agencies and as a result delivery of services was too fragmented.

"The key elements of the reform programme include a major rationalisation of existing health service agencies, including the abolition of the existing health boards or authority structures," he added.

The cornerstone of the reform programme was the establishment of a health service executive which would be the first ever body charged with managing the health service as a single national entity.

Mr Caoimhghin O Caolain (SF, Cavan-Monaghan) claimed that the abolition of health boards was a blow to democracy.