Under the Government's regime, public nursing homes are under threat, as are services for the elderly. Last week, the HSE put in place a public consultation process to consider options for the future of the Cottage Hospital, Drogheda. At the same time, a statement from two Government party Deputies, Deputy Nash and the Minister of State, Deputy O'Dowd, claimed they had agreed a conclusion to this process with the Minister for Health, Deputy Reilly. By so doing, they totally undermined the process, the rights of concerned citizens, the elderly themselves, their families and local representatives. In the programme for Government, the Taoiseach promised an end to the old politics. He promised to honour the trust of the electorate and to break from the corruption of Fianna Fáil. Tá sé go han-soiléir, áfach, go bhfuil an Rialtas mar Fhianna Fáil. Tá sé ag déanamh na rudaí céanna agus níl an córas sláinte ag obair ar son saoránaigh. Tá sé go han-mímhorálta go bhfuil 17,000 duine ar an liosta feithimh ach, ag an am gcéanna, go bhfuil Teachtaí an Rialtais ag deanamh strokes arís.

Strokes.

Strócaí.

Tá siad ag strócáil.

In the management of the health services in the primary care centre debacle and in this little deal concocted by two Government party Deputies in respect of the cottage hospital, one finds the same old stroke politics. The Taoiseach should tell Members whether he believes it is appropriate that two Ministers and a Government party Deputy should undermine a process of public consultation in this way.

Tá fáilte roimh an Teachta Adams thar n-ais mar ní raibh sé anseo an tseachtain seo chaite. In any event, as for the development of the plans for residential services for older people in County Louth, the HSE Louth-Meath primary services unit established a group to identify those options and to address existing pressures on the existing Cottage Hospital, of which Deputy Adams is aware.

That review is now complete. The detailed options appraisal report has been prepared. The HSE Dublin north-east region will publish this report next week and there will be the commencement of a full public consultation process. It has already commenced informal meetings, as the Deputy will be aware, with residents of the Cottage Hospital and their families to discuss concerns they may have at this time. A similar options appraisal report for St. Joseph's Hospital in Ardee will be published in the coming weeks and will be the subject of further discussions. In that regard, the HSE is also involved in discussions about the future of public nursing homes and a conclusion to that will be published by the Minister for Health in due course. Clearly the HSE is also carrying out a viability analysis on the future of all long-stay nursing homes in order to maximise the numbers who should be retained within-----

The private sector.

-----the existing staffing resources. That review will focus on a number of areas, including any home's ability to meet the changed HIQA standards for staffing and availability, clearly in some cases taking into account the structure, the age and the environment of a number of these homes throughout the country.

The Taoiseach has totally missed the point I was making. He said the HSE would publish its conclusions. The Minister of State, Deputy O'Dowd, who is sitting behind the Taoiseach, and the Labour Party Deputy for the area have said, with the support of the Minister, that the conclusions have already been published. They have already said what will happen at the end of this process. I attended the consultation process. What is the point in the HSE having such a process? The point I was making is that this is another case of stroke politics. This is parish pump politics and the people who are suffering are those who are elderly and in need of care.

That is rubbish.

The Minister engaged in this kind of politics in his constituency with the primary care centre debacle. He has also failed to tackle consultants' pay and the price of drugs. He has failed to recoup money from private health insurance companies. He has failed to introduce free GP care - I could go on. However, he has imposed prescription charges on medical card holders, slashed funding from home help services and is closing public nursing home beds, including in County Louth. I will ask the question again. Does the Taoiseach believe it appropriate that two Ministers and a Government Deputy should behave in this way, undermining a process of public consultation?

The Minister of State, Deputy O'Dowd, advises me that funding is in place for the Cottage Hospital to become a step-down facility with more than 30 beds-----

The process is not finished.

-----arising from the options that were published on this matter last week. What is required and what will happen not just in the north east but throughout the entire country is a public consultation about where-----

There is no point doing it.

It is a sham.

-----we want to be with the health system in the years ahead. Clearly we need an effective and efficient system that delivers the best health care for all patients based on their medical requirement as distinct from what they have in their pockets.

That is not what is happening.

The Taoiseach should tell that to the Minister for Health, Deputy Reilly.

As the Deputy well knows, we cannot have centres of excellence at every crossroads.

There are 40 people on trolleys in Drogheda and that is not a crossroads.

There will be changes, which people understand, but it must be as a result of consultation between everybody involved so that when a person becomes sick or has an ailment or a requirement in any part of the country-----

They get a trolley.

-----in the initial case they either have access to a primary care centre or, if it is a requirement for a hospital, they are able to travel there efficiently and effectively in order to get the treatment they need. In respect of the older people, the standards that apply need to apply across the country. The Deputy does not want elderly people in his constituency to be subject to inferior accommodation or facilities. There has been a very big juggernaut-----

It is called James Reilly.

-----for the past 30 years, which needs to be changed and will be changed. While the change is always difficult-----

Nothing happens.

-----it is in the best interests of the country and the people. The main focus needs to be the patient, whether it be a child, young person, middle-aged person or elderly person. That is where the focus of the change and changing structure needs to be and that is where it will be.