Yesterday the House paid tribute to the family of young Frances Sheridan, whose funeral takes place today. The newspapers today carry further revelations which cause serious concern. On 3 September, Dr. Finbar Lennon, medical adviser to the management board of the North Eastern Health Board, advised that there were concerns about the continuity of patient care and the supervision of non-consultant doctors by locum consultants in Cavan General Hospital. Today we learn of a problem with another appendicitis case, described in newspaper headlines as a grave blunder.

Yesterday I charged the Taoiseach and the Government with political responsibility for delivering a health care system that is effective and meaningful to people. The Minister for Health and Children has the political responsibility for delivering that system and I see no merit in the Minister whingeing in public that he is frustrated because he is unable to do his job. The good health of the nation is something that goes beyond mere politics and it is patently obvious that section 24 of the 1970 Act constrains the Minister from doing his job. It is time for some creative leadership from the Taoiseach and I offer him the support of this side of the House in doing so.

We have an aviation authority and a Health and Safety Authority but why do we not have a patient care authority? It would be similar to a surgeon general's office which would have its own chief executive and staff to cut through the bureaucracy which does not allow the Minister for Health and Children to do his job. It would put patient care and continuity of care at the heart of the system, which is what we want.

A question, Deputy.

People are looking for leadership in the health sector and the Minister for Health and Children has fallen down on his responsibilities because of the constraints in the system. I am suggesting a way out of this. We can set up an interim authority to deal with patient care and put that authority at the heart of what people need now. I offer the Taoiseach the support of this side of the House in facilitating whatever time is needed in the Dáil to get that authority up and running.

I welcome Deputy Kenny's constructive remarks, as obviously there are limitations within the legislation. Yesterday Members on all sides of the House sent their sympathies to the family of Frances Sheridan and to those involved in the related case. In the Cavan case, according to the legislation the Minister is the one who must set up the inquiry and nominate people for the teams, which seems overly bureaucratic. People may not want to serve on those teams — one person who was nominated had a conflict of interest because of family connections, which should have been obvious from the start. Then there was a row about the expenses to be paid and we set up the team at the third attempt. This seems nonsensical, as the row went on from August until the Minister was able to appoint the team some months ago. I gave those details yesterday. What is appearing in the newspapers is not unconnected to that issue but I do not want to get into that matter in the Houses of Parliament. I should not have to get into it.

On Deputy Kenny's broader point, obviously the Minister does not have clinical responsibility. He has never had that responsibility and never could have. While I know Deputy Kenny is not saying that, this point is at the core of the issue. The health board, medical health officers and clinical professionals are the people who must make the decisions. Obviously the health board has a role and in many cases the Minister gets drawn in, though historically that was not the case. If one has to provide the service then it must be provided and the Minister has met the relevant people — he met the CEO yesterday as well as other officials of the North Eastern Health Board. They informed him that there were approximately 14 adverse incidents reported to the board and that the board's medical advisers are in the process of reviewing all those incidents. The Minister is meeting a representative of the hospital consultants today and other steps are also being taken to deal with this matter.

On reform, this year we are moving from the health board structure to the hospital service executive system and that will cause enormous reforms of the system. I welcome Deputy Kenny's constructive comments on engaging with this process, which will cover the other points he made on aspects of the health system. Those points are noted.

These issues are not just matters of staff or resources. It is a question of reform and that is why the Government is so anxious to implement a reform programme.

This is where I differ with the Taoiseach. As a politician, my objective is to ensure that life in Ireland is affected by political decisions. Health goes beyond mere politics. We would all like to see an effective health service where we can be proud of the quality of the services we deliver. What the Taoiseach said here is what was given yesterday. We know all of that.

Information given to me yesterday indicated that there will be further cases where the Minister will be constrained by section 24 of the 1970 Act in various other counties. I see a political solution that can impact on the work of the Minister for Health and Children. One such solution is to set up a patient care authority. If an aircraft crashes, the aviation authority deals with that. The Health and Safety Authority deals with health and safety issues at work.

We read litanies of misfortune every day in our newspapers; 200 people waiting for beds, nursing crises, patient care crises, grave blunders. While it is not directly the fault of the Taoiseach or the Minister, people die while waiting for treatment. A political response is required to cut through all of this and have an effective response from the Department of Health and Children.

I offer the Taoiseach help in this area. Priority legislation was rushed through this House twice in the past week. Why can the Minister not bring in legislation to deal with this and have a patient care authority the public would welcome? We should not have patients involved as pawns in rows that go on between different internal power factions.

There is no difference of opinion between Deputy Kenny and me on this issue so I will not create one. For the past two or three years, all sectors of the health service, consultants, nursing staff, junior hospital doctors, non-consultant hospital doctors and paramedics have worked on what they believed was the best solution for a reformed system. Although the policy reform was organised by Government, it did not generate it. It has been set out. Following the announcements of last year, we have now set up the structures. Various committees and groups are working on this. It has to come back to the House in the form of a new health Bill. The issues raised by Deputy Kenny will form part of it. We are fundamentally changing some systems of the past which were incorporated in the 1970 Health Act. There is no difficulty in this.

We are changing from the health board system to a new regime. The hospital executive services and the role of the Department of Health and Children will fundamentally change. Health boards, as currently constructed, will no longer exist. We will have an opportunity to deal with this at a later stage.

I do not wish to be simplistic about this matter. Hospital cases which give rise to clinical difficulties will still exist, but through reform we can bring a far better and more transparent service to the public.

Who is in charge?

This is what the Government intends to do. I thank Deputy Kenny for his offer when we bring forward this Bill.

The Taoiseach is not delivering. Look at the current waiting lists.

I will examine the case in regard to section 24. I will look at the proposal he made.