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Sinn Féin publishes motion of no confidence in HSE Director General - Louise O'Reilly TD

4 May, 2018 - by Louise O'Reilly TD

Sinn Féin Health spokesperson Louise O’Reilly has announced that her party will move a motion of no confidence in HSE Director General Tony O’Brien in the Dáil next week.

Teachta O’Reilly has also published Sinn Féin’s submission to government on the inquiries into the cervical cancer scandal.

Speaking from Leinster House today she said;

“Vicky Phelan has called for Tony O’Brien to be sacked saying he is more concerned with defending the indefensible than doing the right thing.

“Sinn Féin has been forthright in its view that Tony O’Brien’s position is untenable and he must not be allowed to sail off into the sunset with a golden handshake and a generous pension.

“He has presided over this scandal.

“He cannot be allowed to remain in charge of the HSE when the inquiries into this scandal are ongoing.

“The culture of cover up and unaccountability in this state needs to end.  The protection of the institution should not be prioritised over the welfare of our citizens any longer.

“Today we are also publishing the submission we have made to government on the inquiries to be established to look into this scandal.

“We want to see a two step process and both inquiries must be independent with international experts heading them up.

“The voices of the women have to be heard in the process.

“The decision to outsource and the work of the outsourced laboratories must also be included in scope of inquiry.

“The initial scoping/non-statutory inquiry must have full cooperation of all HSE and Department of Health staff including former staff who may have information.

“We must ensure that all relevant documentation required by inquiry is immediately preserved.

“We have drafted potential legislative changes to amend the legislation concerning the establishment of Commissions of Inquiry to generate bespoke terms of reference which will ensure that the second statutory stage of this process can be concluded in a timely manner, in public and will generate answers for the women themselves and society are seeking.”


 Note: Text of the motion;


Fógra Tairisceana : Notice of Motion



“That Dáil Eireann:


  • that accountability in public life in this state is severely lacking and is a contributory factor in numerous scandals across society, particularly in the health services;

  • the urgency to rebuild trust in the administration of Healthcare by the HSE, Department and Government;

  • that this requires urgent reform, leadership and accountability within the HSE, Department and Government;

  • that recent scandals, particularly that of the CervicalCheck scandal, have further underlined the lack of leadership and accountability in the HSE;

  • that the Director General of the HSE, Tony O’Brien, lacks the trust and confidence of the public, of parties and of patients and his continuance in office further erodes the ability of the HSE to rebuild public confidence and calls into question the ability of the public to trust in the effectiveness and independence of any investigation while he remains in charge;

  • that it has been 12 months since the publication of the cross-party consensus report by the Committee on the Future of Healthcare entitled ‘Sláintecare Report’, regarding reform of the health service over a ten year period into an effective and efficient health service;

  • the failure of Government to deliver a response to the ‘Sláintecare Report’ in spite of committing to do so by December 2017;

  • the failure of Government to develop a new funding model for the health service including multiannual budgets to deliver universal healthcare;

  • the failure to fulfil commitments in the Programme for a Partnership Government to:

  • reduce waiting lists and overcrowding in our hospitals;

  • provide new contracts for consultants and general practitioners;

  • recruit additional nursing staff to support increased bed capacity;

  • reduce delayed discharges; and

  • introduce hospital avoidance measures;

  • the failure of Government to develop the Emergency Aeromedical Service (air ambulance) and its extension to a night-time service;

  • the failure of Government to develop a humane approach to the provision of discretionary medical cards to those who are undergoing treatment for cancer and end-of-life care;

  • the failure of Government to fully implement the ‘A Vision for Change’ strategy document, including building capacity into Child and Adolescent Mental Health Services (CAMHS), the provision of counselling and psychological services in primary care and fully populating community psychiatric teams;

  • the lack of equal opportunity and quality of life for people with disabilities by the failure to implement personalised budgets together with a comprehensive employment strategy to aid independent living and social integration;

  • the failure of Government to legislate for a statutory scheme for home-care, to enable our elderly population to live within their community;

  • the important role that carers contribute to maintaining family members at home by supporting their needs by providing respite services, financial support and disability services;

  • that acute hospital bed numbers, hospital consultant numbers  and general practitioner numbers per head of population are below the Organisation for Economic Co-operation and Development (OECD) average and need to be increased to meet that average;

  • that Emergency Department services are struggling to meet the increased demands for acute and complex care, particularly given our increasing population and ageing profile, and waiting times for out-patient assessments continue to grow and waiting times for elective and planned surgery are unacceptably prolonged; and

  • the lack of coherent comprehensive planning to address these issues, lack of governance and accountability to underpin meaningful reform and lack of statutory requirements to meet acceptable targets, for waiting times and annual performance targets as committed to in the Programme for a Partnership Government; and

    calls on the Government to:

  • immediately remove Tony O’Brien as Director General of the HSE as Dáil Éireann declares that it has no confidence in him continuing in his position;

  • work towards the ‘Sláintecare Report’ proposal for a universal single-tier public health service based on need, not on the ability to pay;

  • ensure a coherent implementation plan is immediately actioned to address the increasing lack of capacity and unmet need in our health service;

  • immediately introduce legislation to ensure the delivery of entitlements to services on a phased income based criteria until universal public access is achieved;

  • Deliver expanded entitlements on income grounds only when capacity is available to deliver services;

  • ensure immediate actions are taken to address recruitment and retention of front line staff by improving working conditions, career progression and job satisfaction;

  • work towards expanding diagnostic service availability to seven day access, for both in-patients and out-patients, to speed patient diagnosis and treatment in a timely manner;

  • immediately provide resources and recruit staff to open beds in hospitals which have been closed during austerity years;

  • immediately commence a building programme to expand bed capacity to reach the OECD average per head of population in order to eliminate overcrowding and deal with unmet need;

  • immediately complete negotiations on a new modern contract with general practitioners which recognises their central role in delivering prevention, health promotion and continuing care in the community;

  • immediately enter negotiations on a new consultant contract to recognise their value and role in delivering public care in our public hospitals;

  • recognise the value of fostering and encouraging our nursing staff by improving working conditions, promoting career progression and further education;

  • commit to meaningful and continuing health reform to take into account the continuing changes that are developing in modern medical practice;

  • review the de-congregation model of care as it is clear that a one-size-fits-all model of care is not adequate; and

  • establish that all service users who have been transferred from congregated settings to independent living are progressing positively.”

Submission on inquiries:

A Aire,

Sinn Féin wish to engage to ensure cross party cooperation to ensure that the women at the centre of the scandal around Cervical Check get the full truth, justice and accountability. We believe the work to date has provided the basis for this and we want to ensure this continues in the same vein.

Further to our meeting on Wednesday I make the following observations / suggestions on behalf of Sinn Féin in relation to the inquiry into cervical cancer misdiagnosis:

  • The voices of the women impacted by this need to be heard and they must have an opportunity to input into the process.

  • All inquiries must be held in public (with regard to respecting the right to privacy of the victims).

  • That the inquiries be independent and be conducted by individuals with relevant expertise and be international experts of standing from outside the state who can assure the public and regain their trust.

  • Any and all inquiries must be concluded in as short a timeframe as possible with due regard to seek information and answers as appropriate and to deal with immediate issues of information and accountability.

  • Any inquiry must also take into account the original decision to outsource some or all of this work to laboratories outside the state.

  • In the first instance we believe that a non-statutory inquiry is necessary to gather information and inform the terms of reference for a statutory inquiry.

  • As such a non-statutory inquiry would require the full cooperation of the HSE and the Department of Health that you, as Minister should;

    • direct all staff that they are required to give full cooperation and disclosure to the inquiry and failure to do so would constitute gross misconduct and result in immediate dismissal from employment.

    • use the full powers and authority of your office and that of Government to ensure former employees cooperate with the inquiry

    • ensure that the Director General and the leadership of the HSE enjoys the full confidence and trust of the public in providing the full cooperation and disclosure required by such an inquiry, and no one be in a position to potentially undermine public confidence in the inquiry and jeopardise its independence.

    • ensure that all relevant documentation that may be required by any inquiry be immediately preserved and protected

  • As advised at our meeting we believe that there is scope to amend the legislation which concerns the establishment of Commissions of Inquiry to generate bespoke terms of reference which will ensure that the second statutory stage in this process can be concluded in a timely manner, in public and will generate the answers which the women themselves and society in general are seeking. We have drafted potential legislative changes which we are currently having legally reviewed and will provide copies to all parties once complete. We believe that such legislation could be passed swiftly through both Houses with the cooperation of all parties and groups.

I hope that the above assist you in coming up with a proposal that can help begin the process of restoring the trust between the Irish people and their health service. I hope that you will further consult with ourselves and others in opposition, as well as the victims and their families, prior to final sign-off of the proposals. We must ensure that there is as much consensus on the process as possible.

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