I join my colleagues in offering my condolences and those of my party to the relatives and friends of the Dunne family on the poignant tragedy that has been visited upon them and their community. In particular I offer condolences to Mrs. Mary Dunne, who lost a husband and two sons in recent weeks.

I refer the Taoiseach to today's Order Paper, in particular to the instruments laid before the House under the "Statutory" heading — I refer in particular to Nos. 27 and 28. Document No. 28, for example, is a policy direction issued on 14 July 2005 by the Minister for Health and Children to the HSE to begin a private hospital building programme on the grounds of public hospitals.

The reason these notices are on the Order Paper today is that a discovery was made in my office that the Minister had not complied with the Health Act 2004. Section 10 of that Act requires the Minister, when issuing a policy direction to the HSE, to ensure that within 21 days of issuing the direction, a copy of that direction is laid before both Houses of the Oireachtas. That appears in section 10 of the Act. The Minister was required to do that but she failed to do so. When I brought it to her attention last week, the response was an apology from the Department and a claim that it was an administrative oversight.

How is the biggest and most central plank in the Government's health services strategy, to build a number of super private clinics on the lands of public hospitals, an administrative oversight? Why did the Minister fail to comply with the law? We now know that if this is her central plank, she did not comply with the 2004 Act and she did not tell the HSE.

The Deputy's time is concluded.

She did not consult the chief executive of the HSE about this initiative. Why was a measure, enshrined in statute by the Houses of the Oireachtas, which requires the Minister to take a certain action, not implemented? Why is there a headlong rush, without any democratic mandate, to engage in a major shift in public policy towards an American style of for-profit health services, with the Minister failing to comply with the law?

The Deputy's time is concluded.

If there is anything more indicative of the incompetence of the Government, it is the change in direction from the health strategy that it campaigned on to provide 3,000 public hospital beds in 2002 to this American system, ideologically driven by the Minister's advisers. Does the Government, on the eve of the general election, still propose to proceed with these contracts? When will the contracts be signed? Are there tenders for inspection? Will we be provided with that information, or has the Government called this off, at least in deference to its backbenchers——

Deputy, your time has concluded. I ask you to give way to the Taoiseach.

——many of whom are as concerned about this matter as we are on this side of the House? One of his backbenchers even claims that one of his Ministers has assured him that it will not happen in any event and that "Harney", as he put it, will be thwarted. Is that the case?

An administrative oversight led to copies of two policy directions by the Minister for Health and Children in 2005 not being laid before the Houses of the Oireachtas as required by section 10(6) of the Health Act 2004. These related to a requirement for the Health Service Executive to prepare and submit a code of governance, which was issued on 18 February, and an issue related to co-location of private hospitals on public hospital sites issued on 14 July. Under section 10(1) of the Health Act, the Minister may issue written directions to the HSE for any purpose relating to that Act or any other enactment. Section 10(6) provides that a copy of such policy directions is to be laid before the Houses of the Oireachtas within 21 days.

The Department of Health and Children issued a press statement on 19 April indicating its regret concerning the administrative oversight and acknowledged the error in not having informed the Oireachtas in the manner prescribed and stating that it was taking immediate steps to rectify the situation by ensuring that copies of the policies directions issued would be laid before the Houses forthwith. The documents were laid before the Houses last Friday, 20 April.

On the second question Deputy Rabbitte asked, I would consider it just one of our initiatives in the health area. I do not consider it the main one. We have had many important initiatives, not least spending €500 million a year on the capital programme and employing 40,000 additional staff. The initiative is not based on a European, American or UK system. It is an initiative to transfer private activity from within the public hospital system to privately financed and managed hospitals to free up 1,000 additional beds for public patients and to try to improve the lot and the circumstances of public patients.

The new facilities, as I have said previously, will meet specific requirements, including the ability to admit private patients 24 hours a day, seven days a week from public hospitals — accident and emergency departments and GPs — and the capacity to treat all patients currently catered for in the public hospital, with joint clinical governance. There will be one accident and emergency entrance and service on the one campus.

On the information Deputy Rabbitte asked about, the Department of Health and Children has been informed by the HSE that invitation to tender documents were issued to the short list bidders on 19 April in regard to Waterford hospital, Cork University Hospital, Limerick Regional Hospital, Sligo General Hospital, Beaumont Hospital and St. James's Hospital. Invitations to tender for Connolly, Blanchardstown and Adelaide and Meath hospitals, incorporating the National Children's Hospital, Tallaght, will issue at a later date. Tenders are due to be submitted by 17 May. The HSE will then evaluate the tenders and select the successful bidders during the weeks after it. Following that there will be a stand-off period of two weeks, which must be done under procurement law, before an agreement can be signed. There will be a rigorous financial assessment of all the proposals at that stage. That will take account of value for money and the cost of any expenditure foregone. Obviously, it will take some weeks for that whole process to be followed.

Does the Taoiseach agree that an admitted breach of the Act is not an administrative oversight? If the Act has been breached, surely what has been done is open to challenge by any person wishing to do so. The Taoiseach took up most of his reply by telling me what is in the Health Act. I know what is in the Health Act. The Minister did not know what was in the Act. The reason the documents were laid before the Houses on Friday was because of the questions we caused to be put to the Minister.

I do not know what other initiatives the Taoiseach is referring to when he says this is not the centrepiece of his new health strategy. I do not know whether he is referring to the 200,000 medical cards that were not delivered, the reform of the common contract which has not been delivered or the resolution of the nurses' dispute, which has not happened. Every which way this Government has looked on any initiative, it has come to grief and the sufferers are the public patients waiting for access to hospital care. They are in that position because of the two tier system and where the Taoiseach is heading now——

Your time has concluded, Deputy.

——will worsen that two tier system. The Taoiseach will permit the cherry-picking of the profitable procedures. He will turn the public health service into the poor relation. He is pushing ahead with that without any public mandate, knowing that the country is divided on it, knowing he has no support not just from this side of the House but from consultants and professionals working in the service, and the openly expressed reservations of the HSE.

Why is the Taoiseach pushing ahead in those circumstances or is he saying that no matter when he chooses to dissolve this Dáil, it is not possible between now and then to sign these contracts and that he will get out of it in his usual way by not taking a stand on the Progressive Democrats, by seeming to facilitate it and it will fall when this Dáil falls?

Deputy, your time has concluded.

There are people outside this House who want to know the answers because they know that we need those scarce public lands to provide the extra public hospital beds and the step-down and community care that will free up acute hospital beds and facilitate the smoother functioning of the accident and emergency service. The Taoiseach has no support for this initiative, not even in his own party, yet he tells us that he is pressing ahead and that the invitations to tender are gone out. Does he imply that they can be concluded before the general election because if he does, it is anti-democratic?

Deputy, your time has concluded.

The Taoiseach has no mandate to do it. He did not seek it in the last election.

Deputy, I ask you to give way to the Taoiseach please.

He did not seek it in the programme for Government. He campaigned on a health strategy to provide 3,000 public hospital beds which he failed to do.

I have given Deputy Rabbitte the timescale. Obviously, the timescale to complete the entire process will take several weeks after 17 May so the answer is that it cannot be concluded in the short term because that could run for quite some period. That does not take from the fact that I agree with the initiative. In my view, public hospitals should be for the benefit of public patients. Forty per cent of the activity of public hospitals should not be taken up by private systems, involving private operations and people in private beds, that are taking away the ability of public patients to get into hospitals. That is the current system.

Regarding co-located hospitals on some of the sites, we have about 50 hospitals in the State. We are talking about half a dozen sites. A number of the other hospitals already have co-located private hospitals such as St. Vincent's Hospital and the Mater hospital where they work in co-operation with each other. I have listened to the consultants in many of these hospitals where there is total agreement among the consultants and medical staff on the co-located hospitals in a range of these areas. An area where there might not be agreement is that some other private hospitals would rather private beds came out of the public hospitals and went to their private hospitals, which is a different matter. That might be an argument around——

The Taoiseach knows as well as I do——

Please, Deputy Rabbitte. I listened carefully to you.

I know you did.

Deputy Rabbitte, allow the Taoiseach reply.

There is a clear difference between Deputy Rabbitte and me on this issue. I acknowledge that and I hope he does——

I acknowledge it.

——but I do not accept that the current arrangement where the staff who work in a public hospital designate their beds and their times as private and public patients cannot get in. That is what happens.

The Taoiseach has accepted it since 1922.

That is what happens, and it has grown. The Comptroller and Auditor General's report shows that it has grown.

The Taoiseach knew that before but he did nothing about it.

The Taoiseach, without interruption.

I have no difficulty about the arrangements and what is happening in the transit units, the step-down beds and all those other units, but the issue Deputy Rabbitte and I have been arguing about week after week, an argument which is likely to continue year after year, is that he is happy with the arrangement.

I hope not.

I ask the Deputy to permit me answer. I listened carefully to him.

If we are to continue to fight about it, the Taoiseach is doomed.

Allow the Taoiseach to continue.

The Deputy is interrupting because he does not want me to explain. He would like to turn this into a complicated issue when it is very simple. The public hospitals are losing a significant amount of their public beds to private patients, which benefits those who operate that system.

Now the Taoiseach is defending it.

I want them to be designated for public patients. Ideologically, Deputy Rabbitte should be on my side on this but he has other reasons. When I discussed this with ICTU, it understood the issue. It had a problem with it several months ago. I do not see why Deputy Rabbitte continues to hold to a system that is inherently wrong in that a significant number of private beds are dominating public hospitals and creating the difficulties in accident and emergency units. That is what I believe.

Bertie the chameleon right until the end.