Brendan Ryan (Dublin North, Labour) | Oireachtas source

Our health service is never out of the news and there is a crisis of access for many. People regularly mention in my clinic waiting times for life-changing procedures that are unacceptably long. Our two-tiered system has numerous inefficiencies that prevent resources from getting to the people who need care most. Our current system is inherently unfair and those with health insurance get faster access based on their ability to pay rather than their medical need. This is unjust.

There has been much debate on the White Paper on universal health insurance since it was introduced two weeks ago. I welcome the real beginning of this conversation in the Chamber. However, the debate must be reasonable and based on fact. There is important reform proposed that has the capacity to reform our health service and ensure it will become more fair and equitable.

It is disappointing that, in this Chamber this week, Members are using their speaking time to link universal health insurance to the property tax, water charges and other unrelated issues. This is another naked tactic from the usual sources to appeal to an audience in advance of the local elections. There is enough time and space to debate the separate issues but what we should be discussing here is real reform of our health system.

As the White Paper states, universal health insurance will not be delivered until 2019. This involves a long process and one that needs to be carefully debated and planned, and ultimately delivered. The debate requires some element of long-term vision, which the previous Government lacked and is totally alien to the current Opposition. Reform of our health system is essential. The Government is determined to deliver it. I believe in universal access to health care and in a single-tier health system. The Government is the first to include a single-tier health system within its programme for Government, guaranteeing access to medical care based on need and not on income.

Our health system has been in a state of perennial crisis for years. However, it is not easy to fix 15 years of Fianna Fáil mismanagement of it. It is even more difficult to fix considering we were shackled to the EU-IMF bailout programme for the first two and a half years of our term in government. However, we are looking beyond the next poll and election. We are seeking to deliver a working health care system that is open to all.

Universal health insurance has been the Labour Party's policy since 2002. It is the most efficient and effective route towards tackling the two-tier health care system that has been a defining feature of Irish health systems for decades. The Labour Party, in government, has been fighting for free health care as it is one of the party's core values. We feel very strongly that there should be no barrier to gaining access to health care. We believe that can be achieved in the State; it is not beyond us.

Those most in need should and will have the full cost of their insurance subvented by the State. The cost for others should and will be based on ability to pay. The core of the Government's health reform programme is to put the needs of the patient at the centre of the health system. The initial step of this programme is to bring improved health and well-being, fair access to hospital care and free access to general practitioners by 2016.

I welcome this week's agreement by the Cabinet on the rolling out of free general practitioner care for the under-sixes. The implementation of free general practitioner care for the under-sixes will pave the way for the next strand of patients who will benefit from the health reform programme. It is essential that this first stage proceed with the full support of general practitioners and that it run effectively and efficiently from the outset. I urge general practitioners to respond positively to the invitation to talks on implementation. This phase represents the first in the provision of universal general practitioner access for the entire population, removing the barrier of fees at the point of use.

This is an opportunity for general practitioners to help those people who have yet to feel the effects of recovery and who are still struggling daily. The White Paper we are discussing today is an important part of the preparatory work for universal health insurance. This will be the basis for the following consultation.

Universal health care is the way forward and the Labour Party will be ensuring it happens. We strive to create a better, more accessible and reliable health care system for the people, which they certainly deserve.

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