At last the truth has emerged in the form of substantial and comprehensive freedom of information documents which we received last Friday evening, not through any openness from the Minister, Deputy Reilly, the Taoiseach or the Tánaiste. They reveal how multi-million euro investments in primary care centres were selected by the Minister, Deputy Reilly, who essentially rode roughshod through the diligent and effective work of the former Minister of State, Deputy Shortall, and the HSE. They had previously selected 20 primary care centres in accordance with international criteria, based around the concept of a deprivation index, so that those areas of the country most in need, socially and economically, would get such centres.

The Tánaiste promised me months ago that all documents would be published, even though he refused to do it subsequently. He said that once the documentation emerged it would prove that nothing wrong was done. The decision of the Minister for Health, Deputy Reilly, was supported by Minister after Minister, with the exception of the Minister of State, Deputy Shortall, who took a principled stand. Knowing the chicanery that was going on behind the scenes, she resigned in opposition to the actions of the Minister, Deputy Reilly, and of her fellow Ministers.

Freedom of information requests reveal a shambolic and chaotic decision-making process by the Minister, Deputy Reilly, particularly on the night before the decision was taken and the Cabinet meeting itself. One should note the timeline. On 16 July at 8 p.m., health officials e-mailed the Department of Public Expenditure and Reform attaching the Department’s final list. The list had grown to 35, south Dublin had come off the list and Swords and Balbriggan - both in the Minister’s Dublin North constituency - had been added, along with Oranmore. Swords ranked 130th on the earlier list of the then Minister of State, Deputy Shortall, while Balbriggan ranked 44th. The Cabinet meeting was on 17 July. Health officials informed the Department of Public Expenditure and Reform that “there are changes to last night’s list”. Castlecomer and Oranmore were no longer on the list, while Ballaghaderreen and Kilkenny had been added.

Does the Taoiseach accept the observation of the then Minister of State, Deputy Shortall, that this documentation gives the lie to the excuses and justifications offered by the Minister, Deputy Reilly, on the selection of the sites? Does the Taoiseach also accept that the Minister got it wrong - and that he and the Tánaiste got it wrong in supporting such a decision-making process, which was by any standards of objective observation a poor performance and wrong decision by the Minister on the selection of the sites which are commercially valuable and important in terms of multi-million euro investments?

No, I do not accept that at all. I note Deputy Martin’s concern about the former Minister of State, Deputy Shortall. It is great that he would show such concern for a person who made a decision to retire as a Minister of State with responsibility for health.

I said she resigned.

She resigned.

I thought Deputy Martin would be far more interested in seeing that foundations are cut, that people are employed in building primary care centres-----

Where are they?

-----that GPs buy into them and that we proceed to develop a substantial number of them around the country to provide decent primary care facilities for patients in need of them.

What about Oranmore?

And Castlecomer.

That is where Deputy Martin’s interest should lie. It ill behoves him to come to the House and refer to this matter when he was party to a list on the back of an envelope of 53 towns - without any consultation whatsoever, good, bad or indifferent - for decentralisation, with signs already up around the country about particular people saying that offices were coming to their parts of country.

As Deputy Martin is aware, the criteria used were the deprivation index, the service priority identified by each service in the local health office in the integrated service area and the accommodation assessment. The Minister added in additional criteria such as competition, GP co-operation, the GP-to-population ratio, existing health facilities, pressures on services and particularly acute services, funding options including Exchequer-funded build and lease, and the implementability of public private partnerships. Deputy Martin is aware that there are three possible options: direct investment through the Exchequer from the HSE, the lease option, under which centres would be built by builders and leased to the HSE, and the PPP option, in so far as the economic stimulus package announced by the Minister, Deputy Howlin, is concerned. In that sense the Minister was absolutely correct. Instead of having just a list of 20, in order to get competition and buy-in from general practitioners it was necessary to have more than 20 so that those that did not get across the line, as it were, or those about which there were objections or non-facilitation by GPs could be moved off the list and provision made to build 20 of them under the PPP process. I assume that over the lifetime of the Government at least 80 or 85 primary care centres will be built or provided under the three options I have outlined for Deputy Martin. We need more than 150 primary care centres around the country. Looking at the original HSE list of 227, Deputy Martin himself would acknowledge that is difficult to see how No. 1 differs from No. 59 or No. 98 because all of those factors are required. I am far more interested in getting on with the job of seeing the buildings take shape and providing facilities for patients all over the country.

The Taoiseach is correct to say that I have shown concern about the position adopted by the then Minister of State, Deputy Shortall. The public is concerned about how she was treated. People are equally worried about the lack of concern emanating from the Taoiseach and Deputy Shortall’s party leader, the Tánaiste, about her situation. The public has one basic question: how is it that the Minister who was playing by the rules, who spent 20 months drawing up criteria with the HSE and going through the process meticulously and in a detailed, transparent and objective way, got shafted overnight and had to resign? That is what concerns the public - that the person who took a principled stand in support of communities that her party aspires to support, whose decision-making process was ridden roughshod over, was the person who had to resign. That is why people are extremely concerned.

The Taoiseach referred to various criteria such as GP co-operation, funding options and PPPs. I have in my hands the documentation we received and there is no mention of any of that. For God’s sake, will the Taoiseach stop the pretence? He must stop pretending there were criteria behind the decisions. There were no criteria behind the Minister’s selection of the sites, and it is downright dishonest to suggest that there were because I cannot find them in the documentation. Nobody can. No one has been able to find them for the past three or four months-----

They are not there.

-----despite all the talk of openness and transparency. The PPPs in question involve a collective investment of €115 million. It is equivalent to a tendering operation. Ministers should not be next nor near such a process. It should be a stand-alone process because there are many consortiums all over the country that would like to think, if they are making submissions, that the system is fair, open and transparent. By any yardstick, the system was not fair, open or transparent.

I have outlined for Deputy Martin the three options that are available.

What about Oranmore?

There is direct funding through the HSE from the Exchequer; there is a lease operation whereby the centres are built by providers and contractors; and there is the PPP system. The Minister has already confirmed on a number of occasions in the House the criteria that were set out for the selection of the locations. He endorsed that by speaking about Balbriggan in particular, in which there was a clear danger that the lease option would fall through. In that respect the town was clearly identified as a location for a primary care centre and it was put on the list. As it happened, the lease was finalised and the centre will go ahead separately from the PPP option. On 9 October a report was issued to the Secretary General of the Department of Health by the internal audit unit which clarified for him that there was no connection between the Minister, Deputy Reilly, and the selection of the site or persons related to it.

I came across information recently in which somebody said, after two and a half years in the former Department of Health and Children, and that it took longer to get things off the ground in that Department than in other Departments. The person said that he had just formulated a new health strategy for the next ten years and that he would like to oversee its early implementation. That person was the former Minister, Deputy Micheál Martin, who was at that time in charge of the Department of Health and Children. He was very up-front about difficulties in the Department. When he was in charge of the Department of Health and Children - perhaps he does not remember-----

He was never in charge of the Department.

-----he managed it so well that the Department had to be bailed out with supplementary budgets amounting to more than €664 million. It ill behoves him to come to the House-----

That was over five years. This Government did it in one. A total of €350 million was required in one year.

I remind Deputy Martin as well that he said he would end waiting lists forever in two years’ time-----

The Taoiseach nearly did it in one. He is some boy.

The Taoiseach should give us his quote on Roscommon while he is at it.

-----and when he was asked whether he would be prepared to stand over that, he laughed at the reporter in question.

The Taoiseach should defend his Minister.

Deputy Martin must not come to the House saying he has the answers to every issue that arises.

I would say the Minister is for the chop. The Taoiseach is not giving him any backing today. He is looking shaky.

The Deputy left an unholy mess behind. This is part of clearing it up.

He is a Messiah. He will clear it up.

Under these three methods I want to see primary care centres-----

This is shambolic. There are no three methods.

Have you any job in Europe for him?

-----being built, opened and used by people, thereby offering proper provision of primary care facilities throughout the country.

Send him off to Europe.

We have many more than 20 to build.

What did the people of Oranmore do to the Taoiseach?

Phil Hogan wanted Kilkenny. There was one for everybody in the audience at the end.

Please show respect to Deputy McDonald.