There have been many pre-election promises made in recent days. The Minister for Health has been at it again in outlining his vision of the health services in the years ahead. I suppose this is to camouflage the fact that the pre-election promises of 2011 have not been fully honoured. The vast majority of them have been shredded and totally ignored.

The Minister for Health made a speech recently to Chartered Accountants Ireland in which he effectively outlined the end of the public health services as we know them. He said he is strongly of the view that the hospital groups or trusts, if one likes to call them that, should have authority and freedom to make collective agreements, manage their own assets and payroll and negotiate independent contracts to recruit managers and specialists outside of the constraints of public sector rules in the way semi-State bodies now do. He added, to make things worse, that where these trusts or hospitals consistently underperform in clinical outcomes, patient experience and financial management, it should be open to the provider to transfer management of the hospital for a period to private providers by means of a concession or management contract.

There is a strong attachment to the public health service in this country, although it is under-resourced, underfunded and facing major challenges in trying to provide basic levels of service. That is primarily down to lack of resourcing. Week in and week out, we have seen illustrations of that in our accident and emergency departments across the country. There are consistent increases in outpatient and inpatient waiting lists. Nevertheless, it is important that the Tánaiste, coming towards the end of this Government, outlines whether Labour is in cahoots with the Thatcherite policies of the Minister, Deputy Varadkar, when it comes to privatisation of large tracts or our public health services. Is the Tánaiste in agreement with the concept of farming out our public health services to private management companies, establishing something like an Irish Water, to be managed by an accountancy firm that will not take into account the social need aspects of our public health services? Will the Tánaiste today assuage the concerns out there that our public health services could be handed over to private management companies in the years ahead if Fine Gael and Labour are returned to office?

I understand the speech by the Minister, Deputy Varadkar, was an address to Chartered Accountants Ireland. I suppose that if he was talking to accountants, he may well have addressed the issue of accountants' roles in the various elements of the health services.

What does that mean?

The Minister, Deputy Varadkar, was very clearly giving a personal view. I think he indicated that and these were his wide-ranging thoughts on how the health services might develop as he saw it. He has done that and it is one of the things that people find very attractive about the Minister, as he engaged in very broad-ranging discussions on his views. He did that before the last election-----

It must be a bummer sharing a constituency with him.

-----and I presume he is doing it now before this election in speaking to a variety of areas. The Deputy asked if I agree with what he has to say. I welcome the fact that he is speaking broadly, setting out his own views and giving great thought to them. It does not mean that anybody has to particularly agree with any or all of his views. It is a free country with free speech. In that context, I welcome debate about the future of the health service.

The Tánaiste is looking for his transfers.

The Labour Party view on the health service is rooted in the concept of an organised, efficient, effective and caring health service, delivered for the most part through the public health service. As the Deputy is aware, it has been delivered for centuries in this country by not-for-profit institutions, many of them religious in origin, which have provided care and health services to generations of Irish people. That is where our vision of the health service is rooted.

We inherited the Deputy's party's vision of the health services in the form of the Health Service Executive. It is fair to say that when Fianna Fáil were in government, around 2004, it ran away from the responsibility of holding the Department of Health and the senior Ministry it involved. From there on, Fianna Fáil allocated that portfolio to its then partners in government.

It is the same as what Labour has done with Fine Gael.

They certainly had a very strong view of the role of the private sector in the health services.

Does Fine Gael not?

In its budget submission this year, Fianna Fáil referenced the accident and emergency department crisis but in its pre-budget statement, I did not see it proposing the allocation of additional funding that this Government has provided. We are all involved in a debate and I would not exclude the Deputy's party from being involved with it.

Is it all our fault?

Fianna Fáil has a particular history with regard to the HSE and what it was trying to achieve in health services. We have a health service in this country that comes with a very strong public service ethic. It is really important that we maintain that to the highest degree. We also inherited a sector of the health service that is not-for-profit, with much of it originating with religious organisations and bodies in this country. I see the core of the health service essentially being provided through dedicated public service that puts patients first.

As we recover, we have the problem of allocating sufficient resources to meet all the demands of a growing population and health service demands. Every country in the world, and particularly western Europe, faces that challenge. It is a challenge that the Labour Party in the last budget, together with our Fine Gael partners in government, has sought to address by allocating very significant additional resources to health services in Ireland.

The Tánaiste's party ran away from all its obligations.

It promised to protect those who most needed support from the State-----

Labour's way or Frankfurt's way.

-----and, in every budget it supported in this Parliament for the past five years, it brought forward a tax on the most vulnerable in this society. The idea that the Tánaiste can stand here and say-----

You crashed the economy.

-----we were running away from health is simply a farce.

You destroyed the economy.

Please.

The Labour Party and the Tánaiste were directly responsible.

Deputies, please.

Let me say-----

Deputy Kelleher has the floor.

Let me say-----

You destroyed homes and banks.

Did you sleep last night, Ray?

The Tánaiste is directly responsible for the thousands of people who are in emergency accommodation on a continual basis because of her reluctance to address the rent supplement and the need for an increase.

Take responsibility.

They said it would be €6 billion to recapitalise the banks.

Getting back to my original question.

Deputies, please. Deputy Kelleher has the floor now.

Sorry, a Leas-Cheann Comhairle.

Getting back to my original question about the privatisation of the public health service, the Minister for Health was speaking to Chartered Accountants Ireland. The fact one is speaking to chartered accountants does not mean one should tell them something they would be interested in, because I would be very concerned if we were handing the running of the health services over to the KPMGs of this world.

You handed it over to Mary Harney.

The bottom line is that it is a public health service-----

-----and I would like to know whether the Tánaiste is committed to retaining a public health service.

You were the creator of the HSE.

In other words, it is retained in the ownership of the public and it is run for the public.

The Tánaiste can say it was just a speech that was being put forward at Chartered Accountants Ireland, but the bottom line is that the Minister, Deputy Varadkar-----

Here he comes. I thought the Minister, Deputy Varadkar, had a day off.

Here is the man himself.

The Minister did outline his vision of the health services in the years ahead and he has also outlined the fact, along with Fine Gael and the Labour Party, that the two parties will put themselves as an outgoing Government before the electorate.

Keep Fianna Fáil out again, forever. Keep you lot from wrecking the country.

Fianna Fáil has no credibility. Sit down.

We would like to know whether the Tánaiste supports the concept of privatisation of our public health services. I know the Tánaiste has praised the Minister for Health and obviously he is a constituency colleague-----

-----but leaving that aside, she needs to accept that there is huge concern out there because our public health system is under-funded, under-resourced-----

Whose fault is that?

It is continually starved of the resources it needs to provide basic services. That has been highlighted time and again.

Is the Tánaiste now saying that she is supportive of the concept of handing the management of hospitals over to private companies and undermining the public health services?

I forgot to say earlier, in the context of this Government, I want to congratulate in particular the people in Deputy Kelleher's constituency on the announcement by Apple yesterday of 1,000 extra jobs in the constituency-----

What has that to do with the health service?

I suppose the Tánaiste is going to take the credit for that.

-----in Hollyhill. I know the Ministers of State, Deputies Kathleen Lynch and Dara Murphy, will be very pleased about that.

I hope they are good apples. No rotten apples.

It is a pity the Government was not as interested in the Web Summit

In the same way that Deputy Kelleher probably has a very positive relationship at local level with those Ministers of State from this Government-----

Apples and oranges.

I am sure he does welcome the Apple announcement. It is a great announcement for the northside of Cork.

It has nothing to do with hospitals.

Deputy Kelleher threw out a general-----

An apple a day keeps the doctor away.

An apple a day keeps the doctor away from Leo.

-----remark-----

About the Tánaiste's Department.

----- about the Government.

Can we have order, please?

The Government is doing what it promised to do, which is to restore the economy-----

It promised something totally different.

-----and get people back to work. That is the number one job of the Government.

It never promised privatisation of the health service.

By the way, this year in the HSE we are employing, overall, about an extra 4,000 people-----

One would not have thought that in Kilkenny yesterday.

One still cannot get a bed in Beaumont.

-----which is the first significant recruitment that has happened. My vision of the health service and the Labour Party's vision of the health service is of-----

Go on, tell us.

-----a publicly funded, well-run health service.

Publicly delivered as well.

Where is it?

Bearing in mind, as well-----

Please.

-----the long not-for-profit voluntary health service tradition that also exists in this country.

You are on the privatisation board.

I do not know whether Fianna Fáil wants to see the back of that, but the Labour Party does not want to see the back of the huge contribution of the voluntary sector-----

The Government is shafting them at every turn.

-----and the not-for-profit sector has made to the development of health services in this country.

That is a newfound interest.

Run them out of education, run them out of health.

That is a very important role. I do not know whether Fianna Fáil is saying it is going to shut down all of that, but again I want to say, and I heard Deputy Kelleher refer to chartered accountants-----

Yes. Was the Tánaiste at the Minister's gig?

I have to confess that I am originally a chartered accountant myself and all I can say is that, like lots of other professions, chartered accountants have a wide range of views on different issues. The Minister was speaking-----

What about their role in the banking crisis?

-----and I think it is to be welcomed. He was speaking in a broad way-----

He was not talking about Government policy.

He was talking about his own thoughts and views on how the health service should develop.

This is dragging on for 15 minutes. It is ridiculous.

It would be great if we could hear any views whatsoever from anybody in Fianna Fáil, because since about 2004-----

We are back to the Pat Rabbitte attitude that what one does at election time is to tell them whatever one thinks will get them-----

-----all the party has done is run away.

Please.

By the way, as Deputies know, the funding for health has expanded very significantly-----

You did not know until you got the Vote.

-----in the budget for this year and the funding being committed to health has expanded very significantly. Yes, we have serious problems that have to be addressed, and we are addressing those problems by funding them.

I thank the Tánaiste.

Five years.

Deputy Kelleher is claiming that Fianna Fáil was an equaliser in some way in terms of what happened in this country over the last seven years. Fianna Fáil's form of equalisation is for 300,000 people to lose their jobs and go on social welfare-----

Hear, hear.

Hear, hear.

-----so their income falls.

Let us cut the minimum wage.

Fianna Fáil's form of equalisation is that businesses all over the country close down and then people who own those businesses are much worse off-----

Fifteen minutes of Leaders' Questions. This is ridiculous.

Your form of equalisation is to lie your way through an election.

Fianna Fáil's form of equality is to cut the minimum wage for workers in work by €1 an hour.

Has Leaders' Questions been extended?

That is a poor form of equality.

I can take it that the Tánaiste is not going to answer the question.

That is equalisation for Deputy Kelleher.

Deputies, we cannot hear each other now. I call Deputy Mary Lou McDonald.