It is proposed to take No. 20, Inland Fisheries Bill 2009 — Order for Report, Report and Final Stages; No. 19, Road Traffic Bill 2009 — Second Stage (resumed); andNo. 21 — statements on the final report of the Joint Committee on Constitutional Amendment on Children, to be taken not later than 1.30 p.m. today and the order shall not resume thereafter. It is proposed, notwithstanding anything in Standing Orders, that the following arrangements shall apply in regard to No. 21: the statements of the Chairman of the Joint Committee on the Constitutional Amendment on Children and of the main spokespersons for Fine Gael, the Labour Party and Sinn Féin, who shall be called upon in that order, shall not exceed 15 minutes in each case, the statements of each other Member called upon shall not exceed ten minutes in each case, Members may share time, and a Minister or Minister of State shall be called upon to make a statement in reply which shall not exceed ten minutes; and the Dáil on its rising today shall adjourn until 2.30 p.m. on Tuesday, 23 March 2010.

There are two proposals to put to the House. Is the proposal for dealing with No. 21, statements on the final report of the Joint Committee on the Constitutional Amendment on Children agreed to?

I propose an amendment to the Order of Business that the Dáil shall sit until 6.45 p.m. to allow for statements and questions in regard to the latest catastrophe that has befallen us in the area of health. Yesterday we had priority questions, statements and comments in the House about the situation whereby X-rays were not read by radiologists in Tallaght hospital, with the possibility that a small number of those may have a significant impact on patient medical health. We now understand that this situation is far worse, with reports of thousands of letters unopened from GPs in referral of patients to consultants in Tallaght hospital. This goes beyond the reading of X-rays by radiologists. These referrals may refer to much more serious or prevalent conditions for those concerned. For example, they could refer to bowel cancer, cardiac conditions, analysis in respect of tumours——

We discussed this matter at length yesterday and I am sure there will be other opportunities to do so.

We did not discuss this issue yesterday because we did not know about it.

Thousands of letters were unopened.

The Ceann Comhairle said to Deputy Morgan——

We are on the Order of Business.

The Deputy is proposing an amendment to the Order of Business.

Deputies cannot make a Second Stage contribution on the Order of Business.

I am proposing an amendment to the Order of Business and I want to explain why. The Ceann Comhairle said to Deputy Morgan that if he comes up with a reasonable proposition, he will give him his say. The Inland Fisheries Bill 2009 is important but nothing is more important than the life and death and healthy condition of our people.

Hear, hear.

For the people who have had letters of referral left unopened in bags in Tallaght hospital, this is a crisis. The Minister for Health and Children will not return from New Zealand until 22 March. This is another catastrophe. Deputy James Reilly, on behalf of the Fine Gael Party, has already said that if the Taoiseach decides to reappoint this Minister to the Department of Health and Children, we will move a motion of no confidence against her. The Labour Party has indicated it will do likewise.

I am concerned that we have clarity from the Tánaiste in the absence of the Minister for Health and Children as to what the facts are in this matter. Are we to understand that there are thousands of letters unopened — many of them letters of referral by GPs — in Tallaght hospital? As I said, these letters of referral may refer to serious conditions, whether tumours, cardiac problems, bowel cancer or whatever.

The Deputy will have to find an alternative way if he wants to have a lead-on debate to what went on yesterday. We are on the Order of Business and I have allowed him considerable latitude.

We are talking about letters, not X-rays.

Does the Ceann Comhairle know what is going on outside this House?

It is a matter for the Health Service Executive.

This is the ultimate example of lack of accountability in the political process. This is hands-off Government, hiving off issues to bureaucratic and administrative entities. The Minister for Health and Children should be in the House today but she is not. I want confirmation from the Tánaiste of the validity of the reports in today's newspapers that there are thousands of people walking around who may have serious medical conditions because the relevant GP referral letters are lying unopened in Tallaght hospital.

For that reason, I propose that the Dáil sit until 6.45 p.m. to allow statements from the Minister and from the Opposition and that there be time for questions and answers. This is much too serious for flippant responses. It is a matter of life and death. We in this House should put ourselves in the position of those patients who went to their GP more than a year ago and were told that a letter of referral would be written on their behalf to a consultant in Tallaght hospital only to find this morning that these letters lie unopened. We can imagine the crisis in those people's minds this morning. That is why it is important that we have accountability in this House and that the House sit until 6.45 p.m. to allow time for statements and questions so that we can get answers and get the truth. There must be no more of this lack of accountability in the forum of the people. This is another catastrophe brought down on us by a Government that has lost touch with reality, with the result that thousands of people may well have serious ailments that have not been diagnosed or are not being diagnosed.

The Deputy is abusing the Order of Business.

Patients are being abused. This is worse than the situation in Portlaoise where 97 files were thrown out until a cohort was reached.

I have called Deputy Gilmore.

How many files are needed for a cohort? Is it 20,000?

Deputy Reilly must stop interrupting.

I support Deputy Kenny's proposal that the House sit until 6.45 p.m. in order to hear from the Minister for Health and Children, or some other Minister, and to have questions answered about the additional information we received since yesterday about what has happened in Tallaght hospital. I am supporting this proposal in the first instance because the Government has a separate proposal on the Order of Business today to close down the Dáil until Tuesday week. Therefore, today is our last opportunity as representatives of the people to question Ministers in the Chamber about the situation at Tallaght hospital. We have heard much over the years about things going wrong in the health service, about misdiagnoses, tests that were not followed up, various cutbacks that have taken place and so on. However, of all the issues I have heard about, there is nothing as incredible as the idea that somebody goes to the doctor complaining of something, the doctor decides that he or she needs an X-ray and writes a letter to Tallaght hospital to arrange it, but the letter is never opened.

There were 20,000 letters.

It is incredible. What is going on there? It is one thing to have queues and waiting lists and the worry associated with that, but that a GP's letter should go to the hospital and nobody opens the envelope is utterly incredible. We must have answers to this. I see in news reports——

This is not relevant to the Order of Business.

It is relevant.

Yes, it is. It is a question of accountability.

Lengthy statements are not contemplated on the Order of Business, that is my difficulty. I have allowed considerable latitude to both Deputies.

The Ceann Comhairle should listen a little more and he might learn something.

I have a question for the Ceann Comhairle. Am I out of order?

The Deputy is out of order in the sense that Second Stage-type statements on the Order of Business are not contemplated.

There is no Second Stage statement.

We will have to change Standing Orders if we are to accommodate those types of statements.

I am not making a Second Stage speech.

However, I have allowed the Deputy some latitude and will continue to allow it provided that he is reasonable and truncates his contribution.

I am not asking for latitude, I am asking for my rights as a Member and I will insist on my rights as a Member.

Hear, hear.

I am entitled to make a comment and to make an observation on the Government's proposal for the ordering of business in the House today and that is what I am doing. To underline it, I am not making a Second Stage speech because there is no Second Stage.

For clarity, Standing Order 26 states that in the case of a proposal to oppose the Order of Business, the Chair shall permit a brief statement from each party in Opposition. What is contemplated is a brief statement.

I am making a brief statement and I will make no apology to the Ceann Comhairle or anybody else for underlining the seriousness of this situation——

Hear, hear.

The Ceann Comhairle does not want an apology.

——where people go to their doctor, the doctor refers them to a hospital and no one at the hospital even opens the letter, and, moreover, even when they do get an X-ray, the consultant radiologist does not see it. There are 14,000 patients whose X-rays have still not been looked at by a consultant radiologist in that hospital and we do not know when they will be looked at. Where is the Minister for Health and Children? She is on a two-week trip to New Zealand to celebrate St. Patrick's Day.

Another option for the Deputy is to raise this matter on the Adjournment.

It is an absolute scandal.

I too support the proposition put forward by Deputy Kenny but with no disrespect to the proposition, it does not go far enough. The Minister should be recalled. There can be no other answer in this situation. Have no doubt about it, if the host people in New Zealand were aware of the backdrop to her presence in that country, they would be incredulous that she was there at all.

They would chase her home.

They would never tolerate a similar situation in regard to a member of Government with responsibility for health in their country, who was off doing business somewhere else when the situation at home was in total disarray.

Make no mistake about it — this is a very serious matter. The fundamental basis of the relationship between general practitioners and consultants in our acute hospital sites is in tatters due to this revelation. I made reference to this yesterday in the course of the private notice question, HIQA indicated it had been brought to its attention that referral letters from GPs had remained unopened in Tallaght hospital. We have now learned there could be of the order of 30,000 unopened referral letters, as a GP claimed this morning on "Morning Ireland"

This is an incredible situation. The cry again of the people is: "Is this being investigated?" Who is carrying out the investigation? What are the terms of reference of that investigation? Is a thorough examination under way to confirm or assuage the fears of the people that this is not also the case applying in other hospital sites across the State? These are the critical issues.

We need to know what are the terms of reference of any investigation or inquiry into this matter before we leave this House today. Where were the consultants who have not carried out their work? What were they doing when they were not reading 58,000 X-rays or reading letters of referral from general practitioners? We are paying them. We want to know what they have been doing. What were they doing when they were supposed to be carrying out their duties? Who has oversight of their day's work?

We will have to let it rest at that.

Who has oversight of their responsibilities?

I have a proposed amendment with which I must deal.

You have, a Cheann Comhairle. I am suggesting there are further matters that need to be addressed.

I am sure the opportunity will arise.

This House should be recalled next week with the Minister present before the Dáil. The matter is of such gravity——

The Deputy's co-operation would be appreciated——

A Cheann Comhairle, I am not being flippant about this. The matter is of such gravity that the Minister has every right to make her way back home to face the questions of the Members of this House and to answer the questions that were not answered yesterday, with no disrespect to the Minister of State with responsibility for children, who was not informed enough to answer the questions. That question list has grown——

The Deputy has had a very good innings.

It has grown overnight.

Will the Deputy resume his seat?

I ask the support of the House to bring home the Minister so she is accountable to this House and to the people of Ireland.

Or cancel her passport and leave her out there altogether.

She should send home the Government jet.

Deputy Enda Kenny has moved an amendment——

A Cheann Comhairle, before the Government——

Will Deputy Reilly resume his seat?

Before the Government exercises its majority, which is pretty perilous at the minute——

The Deputy should resume his seat while the Chair is on his feet.

I want them to consider, if it was one of their relatives, one of their children, wives or husbands that was waiting for an appointment based on one of those letters——

The Deputy must resume his seat.

Think of the absolute disdain they have been treated with, the total lack of trust and the betrayal——

When the Chair is on his feet, Deputy Reilly should resume his seat.

I respect that, but if it is not for this House to look after the welfare of our people in our health service, we may all just go.

It is as if Deputy Reilly's profession has nothing to answer for in all of this. This is complete hypocrisy.

A Cheann Comhairle——

Deputy Reilly must resume his seat and Deputy Stagg should do the same.

A Cheann Comhairle, I have a point of order.

Deputy Stagg should resume his seat until I have clarified the position in regard to the amendment.

On a point of order——

I must inform the House as to the position with the amendment. The amendment is not in order because it introduces a new matter. It is a matter for the Taoiseach and it is his prerogative to list the business to be taken today.

Where is he?

We will now deal with the first proposal on the Order of Business. I must put the question. Is the proposal for dealing with No. 21 agreed to?

A Cheann Comhairle, may I make a point of order?

There is a point of order.

Tá an rún rite.

No, a Cheann Comhairle——

A Cheann Comhairle, while I respect your position, this is a classic example of where life and death——

Votáil.

Is the proposal that the Dáil on its rising today shall adjourn until 2. 30 p.m. on Tuesday, 23 March 2010, agreed to?

It is not agreed. Why did the Ceann Comhairle not ask the Tánaiste to respond to the legitimate proposal I made for an extension of time of the Order of Business? I am not objecting to the contents of the Order of Business, rather I am objecting to the timescale for it. I would like the Tánaiste to respond on behalf of the Government. The Ceann Comhairle said that my proposal and that of Deputy Gilmore and Deputy Ó Caoláin introduced new matter to the Order of Business and, as such, was a matter for the Taoiseach. The Tánaiste represents the Taoiseach who does not want to be here on Thursday mornings. I ask the Ceann Comhairle to ask the Tánaiste to respond to the proposition. Surely a matter where potentially serious medical ailments could arise for patients whose letters of referral have not been opened in Tallaght Hospital is a matter the House should consider?

When responding to the first case I raised in this House with the Taoiseach about the medical condition of an elderly lady, he said these cases are too facile to raise in the Parliament. I remind the Ceann Comhairle this is the most important element of who we are and what we do — the life and good health of our people. This is a matter of the most serious concern and I would like the Tánaiste to respond to the legitimate proposition I made here.

Hear, hear. Let us have it, Mary.

I oppose the Tánaiste's proposal that the House should adjourn until 23 March. This adjournment, we are led to believe, is to facilitate Government Ministers travelling abroad to represent Ireland on St. Patrick's Day. It is a good thing that Ministers represent Ireland on St. Patrick's day and that we maximise the opportunities it gives us to promote the country.

Who will be travelling to Angola?

St. Patrick's Day, however, is one day and at best, St. Patrick's Day events are organised for a couple of days around it. We now have a Minister, however, who is on a visit to New Zealand for two weeks on an itinerary that according to the newspapers today reads more like "The Lord of the Rings" trail than it does like a State visit; the only thing missing is dinner hosted by Bilbo Baggins. Meanwhile, the health service for which she is responsible is falling apart.

We have already had the episode in Tallaght hospital. There is a also report, that has not been officially published but which has been leaked, on the organisation of the Department of Health and Children that states, according to The Irish Times, “The Department of the Taoiseach has run its rule over health and found a department under siege from the seemingly endless crises afflicting the sector. Staff are frustrated and disillusioned, morale is at rock bottom and leadership is uneven at best”

Leadership is missing in action, like the Minister.

In another report it is stated that some staff in the Department have little or nothing to do while colleagues are overwhelmed with work but management appears reluctant to deal with the problems.

It is one thing to have the country represented abroad on St. Patrick's Day but the abuse of that on this occasion is not acceptable and it is not acceptable to the Labour Party that the House should adjourn until 23 March when there are serious matters, including the problem in Tallaght, that need to be addressed and that the Government has insisted we cannot discuss today.

I propose that the Dáil sit for one full day in the coming week, either Thursday 18 March or Friday 19 March, to accommodate the return of as many Ministers and Ministers of State from wherever they may be over the St. Patrick's Day period. It is imperative that the Minister for Health and Children is recalled to face the serious crisis presenting in our health service, a crisis built on crises over the years. There can be no doubt in anyone's mind about the real fears and the public disquiet over this matter. It is most likely that the issue is not unique to Tallaght hospital. It beggars belief that Tallaght hospital would be a unique aberration within the network of acute hospital sites across this State.

This is serious repetition. We had this on the previous point.

I am stating clearly that we require a full investigation to establish all of the facts, to assuage people's fears by addressing the failures within the current system and to restore confidence by taking the appropriate steps to ensure this never happens again. There are core questions in this issue, the Minister's accountability being one, but there is also the accountability of those we pay within the health services. I want to know what these consultant radiologists are doing if they are not reading X-rays.

Standing Order 26 allows for brief statements on the Order of Business and the Deputy has gone beyond that, much beyond it.

I have not gone beyond it, this is a hugely important matter. If they are not reading the X-rays and ignoring referral letters——

Please, Deputy.

With respect, I am an elected Member of this House.

I respect that.

I am also a spokesperson on this issue and I insist on my right to explain why I am opposed to the Order of Business.

Must I explain that Standing Order 26 does not contemplate long contributions on the Order of Business?

I am stating clearly that we need to know what is at the base of the systems failure within the Tallaght experience and if the same exists in other hospital sites, that the difficulties are being addressed and that steps are being taken to ensure this does not recur.

It is now beholden on any Opposition party that is providing pairs for Government Ministers, specifically in the case of the Minister for Health and Children, to withdraw from those arrangements.

The Deputy is going off on a tangent.

No, the Minister should be here. She has lost any right for corresponding support and I call on Opposition parties to withdraw any pairing arrangements during the Minister's absence from this Chamber and this country at this time.

These are serious issues. The practices are unacceptable. The most important people to be spoken of in this House are the patients. That is why the clinical review is hugely important and it is the patient care that must be addressed and that is exactly what is happening.

We all agree that we must have the facts, we cannot form a judgment unless we have all the facts of the situation. New facts arose yesterday evening and they will have to be deciphered and that is why the independent investigation is being carried out by the HSE.

The letter must be read before it can be deciphered.

Perhaps they should X-ray it.

This is an independent hospital and it will have an independent investigation.

It is funded with public money.

It is funded by the taxpayer.

It is funded by the Minister for Health and Children.

It is also appropriate to say that it is easy for Members to personalise issues and to use opportunities like this, unpalatable as they might like to hear it from me, to use the distresses of patients for political opportunism.

That is a shameful comment.

There are questions to be asked of management, of the board, of governance and questions will have to be answered.

The Tánaiste must be allowed to continue without interruption. We proceed on the basis that whoever is in possession is allowed the floor while he or she speaks.

There are questions to be asked on governance and questions to be answered on why the service that is expected of those employed by the State was not provided for clients and their representatives, the GPs. All of that is being investigated. We will await the outcome of the investigation so we can establish the facts.

Are there terms of reference for any investigation?

The issue was raised in April 2009, 11 months ago.

I will ask the Deputy to leave if he does not desist.

We may as well all leave.

Clearly the clinical reviews are there to support patient care.

Deputy Reilly must resume his seat. The Tánaiste must be allowed to speak without interruption.

All of the issues will be dealt with in the investigation. Once it has been completed, changes that must be made will be made and the Minister will deal with them when the full facts are available to her.

Perhaps someone might have listened to one of Deputy Reilly's colleagues, the GP who was bemused about why the Minister for Health and Children has been brought into this when the investigation is about the non-delivery of services to patients in that hospital.

There is one Minister without a party and one Minister without responsibility.

The Deputy should resume his seat or leave the House.

That is what is wrong here.

If he does not resume his seat, I will ask him to leave the House.

She knew about it last year.

There is no accountability and no respect for the people.

Deputy, resume your seat.

I will respect the Chair when this Government respects the people. It is outrageous.

There is a serious lack of accountability.

I call the Tánaiste to reply.

All we are getting are facile comments.

Deputy Reilly, please.

He is annoyed because NAMA is taking over his business.

It is on that basis that we await the investigation so that we can deal with the facts on the floor of this House if necessary.

The Deputy should be made to withdraw that.

Deputy Kehoe, please.

Say it outside the House.

The Tánaiste, without interruption.

Issues are emerging which will be dealt with by the investigation.

They were emerging for the last year.

The investigation will bring to light the reason the issues arose, how they will be addressed and why they should never happen again.

If the Deputy knew about them, why did he not do something about them?

Deputies, please, allow the Tánaiste to continue without interruption.

On the issue of St. Patrick's day——

He would be ashamed of his country today.

He would be looking for an X-ray.

Deputy Feighan——

He can come back again because there are a few Smithwicks left.

This is an occasion which is used by every Government to spread key messages abroad——

Sun yourselves on the beach.

——attract foreign direct investment——

Lie on the beach for two weeks.

——and support our own industries abroad whether they be in tourism, food and beverage or whatever.

How much foreign direct investment comes from New Zealand?

A substantial programme of work has been given to all Ministers and on that basis, unlike any other country in the world, we have an opportunity to sell Ireland as a place to do business and to support our indigenous industries. Ministers are travelling on that basis and the Taoiseach will take advantage of these opportunities when he travels to the United States to meet that country's President, seek out new foreign direct investment and support our indigenous industries. For that reason, I am not prepared to change the Order of Business.

I ask the Tánaiste——

Deputy Kenny, we have spent one hour on the Order of Business.

I want to be helpful to the Tánaiste.

Deputy Kenny, briefly.

The Tánaiste is incorrect with her facts. Other countries have special days, such as Bastille Day or the Fourth of July.

For God's sake.

Deputy Kenny, please.

Nonsense.

He is completely out of order.

I want to be helpful.

Is that the former Minister for Tourism and Trade who never travelled abroad?

He will have to find an alternative way to pursue his argument because he cannot do so on the Order of Business.

I am trying to be helpful.

I ask the Deputy to be very brief.

He knows that is not true.

Allow Deputy Kenny to make a brief contribution.

Deputy Roche is wearing his ministerial tie today.

I thank the Deputy but he knows what he said was untrue.

He was the only one to talk his way out of the job.

Withdraw that comment.

The Tánaiste referred to making judgments when the facts are known and spoke about emerging issues. One fact is that the Minister for Health and Children will be in New Zealand for a fortnight.

Deputy Kenny, please, we have been dealing with this for the last hour.

The second issue I would like the Tánaiste to address, because I am sure the Government is anxious to ascertain the truth, concerns the reports that by last summer there were up to 30,000 unopened letters in Tallaght. The figure may have since decreased but given this is an emerging issue, what are the facts of the matter? Is it a fact——

The Order of Business is not Question Time.

——that there are thousands of unopened letters?

It is not Question Time.

I am sorry, this is too serious.

It is not possible to seek that kind of detailed information on the Order of Business. He could put a parliamentary question, a private notice question or a matter on the Adjournment. There are many alternatives.

I will sit down in a minute.

I have allowed the Deputy significant latitude. He should be very brief.

I proposed that the Dáil should sit later this evening. In the interests of the thousands of people concerned, I would like the Government to tell us whether it is a fact that thousands of referral letters to Tallaght hospital lie unopened? Is that a fact, "Yes" or "No"? Can we take it as the truth?

A Cheann Comhairle——

Deputy Gilmore, briefly.

The last thing I would do is mislead the House.

Intentionally anyway.

I recall Ministers over many years being expected to establish facts without them being available.

The information is available.

There is a dispute at the hospital arising from the issues which came to light last night. These matters will be raised by the Department——

In here at 5 p.m.

——when it meets the CEO to establish the facts of the situation.

When is the meeting being held?

I will not pre-empt that meeting but the facts will be established following it and all the issues will be investigated. Arising from that investigation, judgments can be made one way or the other. At the end of the day, the protocol is in place, the matter is being dealt with, the clinical reviews are taking place and the practice whereby a consultant radiologist examines X-rays has been re-established.

Are there thousands of unopened letters at the hospital?

The matter of the letters of referral from GPs is being raised, probably at this moment, between the Department and the CEO——

There should be a statement to this House on the actions that will be taken.

——and then the facts will be established.

Deputy Shatter, allow the Tánaiste to continue without interruption.

I remind the House——

There should be a statement in this House on the investigation and its outcome.

When the facts are available.

We have to establish the facts before we can comment further.

We need to dispose of the Order of Business.

I have a question for the Tánaiste.

Briefly.

The Tánaiste has said the facts——

Deputy Kenny, please, you are making a mockery of the Order of Business.

This Government is making a mockery of the Order of Business.

The Tánaiste has said, and I thank her for it, that probably at this moment——

The Order of Business is not Question Time.

——these facts are being ascertained.

There will be further opportunities to deal with these matters.

I want to know——

Deputy Kenny, resume your seat.

Show some respect.

Deputy Kenny is not showing much respect to the House.

——why the House cannot sit later this evening to respond to the meeting currently taking place.

The Deputy is not being helpful.

Ceann Comhairle, I am being helpful.

You are being quite disruptive.

These questions are being investigated to determine the facts. I want to know whether the House can sit for a further hour this evening for statements and a report on the meeting that is taking place at present so we can establish the truth.

I am sure Deputy O'Connor would like the House to discuss the matter.

It is in the interest of patients.

He is nodding his head in assent.

Deputy Reilly, please. I call Deputy Gilmore on the Order of Business.

The country is scandalised by what has happened in Tallaght. We need to get answers on behalf of the people, including the patients involved, and accountability from the Minister for Health and Children. The proposal to adjourn the House until 23 March is causing considerable difficulty. We have already voted on an earlier proposal and the Ceann Comhairle told us that the proposal that the House should sit until 6.45 p.m. to hear from somebody regarding what went on is out of order. That is his call.

When Ministers go abroad for St. Patrick's Day, I understand it is normal practice to transfer ministerial functions to another Minister. I ask the Tánaiste to whom——