Sorry, no. I am calling Deputy Gerry Adams.

Deputy Martin, please. I have called Deputy Gerry Adams.

He never listens.

Can I have order, please, for Deputy Adams's question?

The test for good hospital services is that patients get the best treatment possible and they and their families have confident that this is the case. It is clear at the moment, despite the excellent work being done by health professionals and health workers, that this is not the case for many people. Yesterday's reports on hospitals groups and the framework for smaller hospitals have been described by the Minister for Health, Deputy Reilly, as a "fundamental modernisation of our health system organisation in line with best international practice". That is more or less what Deputy Micheál Martin stated as Minister for Health ten years ago when he claimed that the Hanly report would "change forever the landscape of the Irish Health Service".

Irish people are rightly sceptical about false dawns. If there is real potential in yesterday's proposals there must be full consultation with hospital users and local communities. They need to know whether these reports will actually affect the quality of health services for them and their families. Unfortunately, that information is not in these reports.

We must also factor into this that there is not much confidence in the Minister for Health and that there is outright opposition to the Government health cuts agenda. There is widespread concern. I have seen it in my constituency with regard to ambulance services. We have heard of the terrible tragedy of the toddler, Vakaris Martinaitis, who died after a fall in Midleton. This morning there were 290 patients on trolleys. Many hospitals have already lost 24-hour accident and emergency services and more will do so. That is clear from the report. There is a serious information gap in this report in respect of the detail of what services will be allocated to which hospitals. Will communities be given details? Will there be full, inclusive, meaningful consultation?

The answer to Deputy Adams's last question is "Yes". There has been extensive consultation in the last period with consultants, doctors, agencies, organisations, the people and with public representative about the major hospitals, the lower-tier hospitals and local hospitals. The impact of this is to have a situation whereby it is clear that medical personnel are working in teams in the interests of their patients. Generally, this has received a broad welcome from medical personnel working in hospitals. Contracts in future will no longer be to individual hospitals but to the group. There is an 18 month period for testing the effectiveness of this approach.

As the Minister pointed out, not every hospital can offer all specialties but there can be a system that operates in the interests of the patient across the country. These groups will eventually evolve into hospital trusts where chief executives and operators in each hospital will run their affairs in an efficient and effective way. We like to think we can by changing the structure of the delivery of hospital care make it in the best interests of every patient. Deputy Adams is an example of international health facilities and good luck to him in that. I am sure he could have got an even better service here in Ireland had he chosen to do so. This is one of the most fundamental changes in the structure of the delivery of health care through our hospitals in decades. It has taken extensive consultation to bring it to this point. There were a number of locations around the country where people were genuinely concerned that hospitals might close and they would be denied a range of services. That is not the case; the Minister has confirmed no hospital will close and smaller hospitals will have a range of different opportunities to provide services that are more appropriate for them and will keep them busy.

The Government is working very hard with medical personnel to reduce trolley waits. Consultants now see, treat and discharge patients on a 24/7 basis. The establishment of the hospital groups is another milestone in the changed structure and nature of health service delivery.

The Taoiseach opposed that policy when he was in opposition.

It will take some time to see the real effect of these changes but it has been talked about for many years and at last we have a Minister who has put it together with a very fine report from Professor Higgins to see it is implemented in the interests of the patient, unlike the situation Deputy Adams would be aware of, where report after report gathered dust on shelves for years.

The Taoiseach is a late convert.

This is doing something about it that is credible, practical, logical and in the interests of the patient. There will be a better delivery of a more effective and visible health service in the interests of the patient.

Dusty shelves, Deputy Kelleher, dusty shelves.

Welcome to Cork, Deputy Deasy.

It may be the report has potential, we must wait and see. We must factor in the lack of confidence in the Minister and the fact he has broken promise after promise. He entered office promising to restore emergency services to Roscommon General Hospital and he broke that and other promises. It is deplorable, as it is for the family involved, that a patient should spend a night on a trolley. We have repeatedly raised this issue - Deputy Ó Caoláin before me - and it is totally deplorable. We must also factor in the fact the Government is cutting resources to the health services, not enhancing them.

The Minister is reported as saying yesterday that his proposals will make it more difficult for rogue operators to inflict damage on patients. We deserve to know who these rogue operators are. We deserve to know what patients have been damaged and what the damage was. Across the State the same system that existed under the last Government is in place, with people struggling with the same excessive GP fees and numerous beds lost, along with services and staff.

I do not recognise the consultation process the Taoiseach outlined earlier on. I have been consulted as a Teachta Dála but in terms of local communities of hospital users and their families, that is not a mark of how we do our business in this State. Would the Taoiseach acknowledge there is genuine concern about what these proposals mean for local hospitals? There must be a consultation process to clear that up. Could the Taoiseach clarify the Minister's remark about rogue operators inflicting damage on patients?

As Deputy from County Louth representing Drogheda, Deputy Adams should not have to ask that question about rogue operators. What is involved here will put an end to that. Accountability and transparency, with effective delivery of hospital and medical services for all people, are what is at stake. We do not want to see a repetition of the scandals in the north east in the past. We will not tolerate that and that is why the structure is being changed so there is real accountability and transparency. Deputy Adams above all people should know that question should not have to be asked.

I know what happened there. It was a systems failure and there is no evidence it will be corrected by those proposals.

It shows how the Deputy is so disconnected from his constituency that he does not know what went on there.

I know exactly what went on and Deputy Shatter, as Minister for Justice and Equality, would not rectify it.