These are interesting times in Irish politics. Last week I asked the Tánaiste if there was any trouble in Paradise. I remind the Taoiseach that today is the feast day of Our Lady of Perpetual Help. It might be a good idea for him to start lighting candles on his side of the House because it seems that with every passing day this Government needs more help from some quarter.

A few weeks ago the Taoiseach told Dr. Bird on RTE that he would be happy to have his Government benchmarked against the performances of other Governments. He should be careful about what he wishes for because he has got it with a vengeance in the Euro Health Consumer Index report in which, despite this being the second richest country in Europe, it comes in as second last on health care rankings, behind Latvia, Slovenia, Estonia, Hungary and the Czech Republic. Only Lithuania performed more poorly than we did. On the survey's bang for the buck score card this country finished last of 26 and that report showed up rampant MRSA infection in hospitals, bad scores for infant deaths, and very bleak medical outcomes.

That is a collective failure of the Taoiseach's Government which, when combined with his previous Government, will have been in office almost ten years next year. The Taoiseach has appointed three Ministers for Health and Children, one as bad as the other. Is it any wonder that today the Tánaiste on national radio distanced herself from her predecessors by saying that for the first time in many years decisions are being made on the basis of what is best for patients? That is a ringing endorsement of the former Ministers in the Department of Health and Children, Deputies Cowen and Martin. It is good to see that Cabinet collegiality is alive and I suppose, kicking.

Kicking is right.

Health is not the only area in crisis because the Central Statistics Office figures released today show that murder, rape and assaults are up by one third between 2000 and 2005. Does the Taoiseach not accept that the reports of increasing murder rates etc. are not only an indictment of the Government's performance but also an indication it is in freefall from chaos to chaos? Does he agree it is perhaps time for him to move over and let the people have their say?

Hear, hear.

I said to Dr. Bird — that is not what I usually call him — that I would be glad for our resources, our economy and where we are going to be benchmarked as part of an independent assessment. I do not consider the Euro Health Consumer Index 2006, which was produced by a private organisation that is obviously doing its best with limited resources, according to what it has said——

Shoot the messenger.

No, I think it has been doing its best. I thought Deputy Kenny made some good points. I remind him that a great deal of the data used in the survey related to 1997, when he was in Government.

The Taoiseach is saying we are responsible.

He might as well go back to 1916.

Is it much better now?

According to the report, a great deal of the data on which it is based dates from 1997.

It uses 2004 data.

I can benchmark where we were in 1997 with where we are now.

The Taoiseach should admit that we have been relegated.

I am simply reminding the House of what the report states.

The Taoiseach is afraid to look at the data.

The Taoiseach, without interruption.

The report uses current information.

Deputy Kenny is entitled to hear the Taoiseach's response.

The survey states that its conclusions should be considered "with great care". It makes it clear that one part of its analysis is "an academic exercise" and "certainly lacks scientific support". That is what it says. Those who compiled the report did not make any contact with the permanent representatives in Brussels on the matter. The Department of Health and Children has been unable so far to find any evidence of requests for information.

The Taoiseach's team will not find the same.

In other words, a report on our health service was written without any information whatsoever.

There was nobody answering the telephone that day.

The report makes it clear that cross-national comparisons of health care systems, outcomes and delivery are notoriously difficult and are based on standardised statistical indications and data. The survey is based in part on published data from international organisations, such as the Organisation for Economic Co-operation and Development and the World Health Organisation, between 1997 and 2002. That data is benchmarked against up-to-date data from other countries. For example, the data used in respect of the Netherlands is from 2005. I acknowledge that the organisation which produced the report did its best, but it did not take account of the most recent comprehensive survey of patients' views, which was conducted in 2004. Some 4,820 patients responded to that survey, which was conducted by the Irish Society for Quality and Safety in Health Care. The survey found that nine out of ten patients would return to the same hospital for treatment and would recommend that hospital to a friend.

That is just one survey.

The Deputy does not want the truth.

Nine out of ten patients were satisfied with the level of privacy and confidentiality they received and nine out of ten were satisfied with the manner in which their diagnosis had been communicated and found that information easy to understand.

Were any of them from Monaghan?

There is no problem at all, according to the Taoiseach.

Some 95% of patients felt they had been treated with dignity and respect.

Those results are Ceaucescu-like.

The report mentioned by Deputy Kenny refers to none of that. It takes no account of life expectancy, which is the most basic indicator of health. People in Ireland are living longer.

They are not living for much longer.

Life expectancy increased from 75 years to 78 years between 1990 and 2002.

That is quite low.

It is in line with increases in every developed country. The part of the Euro Health Consumer Index report that relates to general practitioner waiting times makes a blanket statement that patients in Ireland do not enjoy same-day services from family doctors. That is simply wrong. Irish patients are able to avail of GP services — over 42% of them have medical cards or GP medical cards. If the report in question gets something as basic as that so fundamentally wrong, I do not know why I am here answering about it at all. I have to do that because that is what I am paid to do. General practitioners in every parish and community in Ireland see their patients on a same-day basis on most days of the year.

Where did the Taoiseach get the figure of 42% of people having medical cards?

It is more like 30%.

Where are the Deputies getting their figures from?

On the issue of direct access to specialist care consultants, the reports states it is not accepted internationally that the best way to organise patient care is for patients to go straight to consultants without the advice of their family doctors. It is not an accepted mark of quality in health care. The health care needs of the vast bulk of patients can be met through GP care. The practice in this country is that people go to their GPs and then on——

Many people cannot afford to do that.

If our entire health care system is entirely wrong and we should not have GPs at all——

Who said that?

If that is the benchmark the Deputies opposite would like me to adopt——

The Taoiseach said 42% of people have medical cards.

Dr. Dolittle.

I will allow them answer the GPs in such circumstances.

The Taoiseach has lost the plot.

I have enough problems getting them to work at night, even when I want to pay them to do so. If others want to tell the GPs they are not necessary, they can go ahead and do that. The Euro Health Consumer Index survey also mentions cancer treatment, but I do not have enough time to go into that in detail. The report misses the point, which is that the huge decrease in——

What about BreastCheck?

I remind Deputy McManus that this is a Fine Gael question. It is not her question.

I do not mind answering them all, a Cheann Comhairle.

Deputy McManus's party will get an opportunity shortly.

The Ceann Comhairle should tell the Taoiseach to stop provoking me.

The Deputy is a closet Fine Gaeler.

The report ignores the fact that there has been a decrease in cancer mortality among people under the age of 65. I would like to inform Deputy Kenny, before I answer his second question, that if he wants me to stand over the findings of a few people who slapped a bit of a report together and put it up——

If he wants me as Taoiseach to take it seriously, on the basis that someday he might find himself over here answering that kind of stuff, although it is unlikely——

We will be over there shortly.

I would not do that. This country's child mortality rate and maternity system, for example, are second to none.

It is more negative campaigning.

I am happy to stand here and defend our health service against a crowd of geniuses who did not even bother to get facts — that is the point.

What about teamwork?

I am glad to know the Taoiseach realises that people in this country are living longer. I accept that fact, which everybody knows. I asked the Taoiseach to comment on the findings of the Euro Health Consumer Index report and he commented on them. The director who wrote the report said this morning that he asked for information from the Department of Health and Children and the Health Service Executive, but he did not get it. When one looks for information but it is not supplied, one has to wonder whether it is because the Government did not want to make it available.

That is right.

The Taoiseach read out the usual litany that he reads out.

I gave the facts.

The Government is on the verge of disintegration in some cases.

The Taoiseach outlined the truth.

The Taoiseach's comments will not reassure the sweet 16, some of whom are behind him at present.

Is that what the Deputy was told to say by his US advisers?

Even though there are 13 subcommittees, it is proposed to establish another subcommittee of backbenchers.

The Deputy is waffling.

They know, we know and the country knows that the current expenditure of €13 billion on health is subsidising problems rather than solving them.

Hear, hear.

They know, we know and the country knows that collectively, the Government has been found out. After nine and a half years in office, is the Taoiseach not prepared to admit there is a sense of desperation among Fianna Fáil Deputies who are knocking on doors? Those who are afraid to knock on doors have an egotistical ambition, the likes of which I have never seen before, which is causing chaos within the Government. It is dangerous, chronic and contagious. Will the Taoiseach comment on the Tánaiste's comment earlier today that for the first time in many years, decisions are being taken on the basis of what is best for patients? Can he stand over the decisions taken by his Government when the Ministers, Deputies Cowen and Martin, were responsible for the health portfolio? Were decisions taken under their leadership on the basis of the best interests of patients? The third Minister for Health and Children to be appointed under the Taoiseach's leadership says decisions were not taken on that basis.

The Deputy's time has concluded.

The Ceann Comhairle gave the Taoiseach a very long run.

The Deputy has been given an equally long run.

I will produce the timings for the Ceann Comhairle if he wishes.

I should have asked the Deputy to conclude over a minute ago.

I will finish by saying that we have had some drama, in the week in which the famous Hollywood producer, Aaron Spelling, died. The Taoiseach was forced to do a Mae West with the backbenchers — "why don't you come up sometime and see me?". The Tánaiste opted for Lady Thatcher — "I am not for turning". He who is not present here — the Minister for Justice, Equality and Law Reform, who does not want to come into this Chamber — turned to the tragic personality of Marilyn Monroe — "all of us are stars and deserve the right to twinkle".

Deputy McDowell does not want to come to the Chamber.

That shows how seriously Deputy Kenny takes his reports. However, I will not go down the same road. There is a lot to be done in the health service and we have reformed much of it.

A lot done all right.

Deputy Kenny's point is partly correct because the report stated we have, correctly, abandoned the health board system. I would rather consider the OECD report on health data. While the survey group worked from international data, it obviously picked up on the necessary reform of the outdated system of the health boards which existed for three and a half decades. The Government reformed that system.

It was Fianna Fáil which introduced them first.

It took us time to change an old and dated system which originally replaced the local authority-based system. We have amended and centralised the old system into the Health Service Executive. The Government has also made large improvements in the health service along the way. Latest figures from the Health Protection Surveillance Centre show that national uptake rate for polio vaccination is 91%. This is not a poor performance by international standards. I am not in the House to berate Members but to answer questions. However, the Health Consumer Powerhouse study used figures from 1997. That says where we were in 1997, but I will not go into that.

The survey states, when commenting on financial strains in the French health care system, ranked No. 1, the budget deficits in health care are more or less arbitrary and not significant. It is the first time I have ever read that in a report. No Government or taxpayer would agree that it was a matter of indifference whether health care budgets are managed profitably. I answer questions in the House regularly stating this should be dealt with. The survey used wrong figures for acute beds.

I know the order of these matters. Two reports were published yesterday; only one got the headlines. The OECD report used health data for this year. However, that would not suit the case, so the headlines were all about the 1997-99 figures. According to the OECD's Health Data 2006, published on 26 June, health spending has grown faster than gross domestic product in every OECD country except Finland between 1990 and 2004. The data show that health spending in Ireland accounted for 7.1% of GDP. The average spend across OECD countries was 8.9%. In terms of health spending per capita in 2004, Ireland ranked above the OECD average. The report stated:

Health spending per capita in Ireland grew, in real terms, by an average of 9.1% per year between 1999 and 2004, one of the fastest growth rates of all OECD countries and significantly higher than the OECD average of 5.2% per year.

It acknowledges the large increases and improvements introduced by the Government. Perhaps in the interests of balance, those who only read the one report should read the other significant report.

We still have a shambles of a system.

The Deputy would know all about it.

A Cheann Comhairle——

I do.

I am sure he does.

Allow Deputy Rabbitte without interruption.