Joe Higgins (Dublin West, Socialist Party) | Oireachtas source

The Government's universal health insurance policy is designed to lead to further wholesale privatisation in the Irish health service, particularly in the area of hospital care. If anyone doubts this, all he or she need do is return to the source of this policy. I refer, in this regard, to the FairCare document which was published by Fine Gael five or six years ago. That document is brutally clear on what Fine Gael envisages in the context of universal health insurance. It states that "At the moment, Ireland has two administrative systems for health – one public (the HSE) and one private (the insurance companies) ... Over time, these two systems will become one, run by the insurance companies." There we have it. The policy of this Government is to hand the health service - particularly that part of it which relates to hospital care but also other elements relating to other forms of treatment - to private health insurance companies, which exist solely to make private profits. The maximisation of private profits is the key responsibility of the chief executive offices and the boards of these companies. It is their job to make profits for those major shareholders who invest in health care one day and in spuds, coffee or petrol the next. The nature of the investment does not matter to the shareholders in question.

It is simply a matter of where the profit comes from.

What we will have, therefore, is a system where private business will be dictating to doctors and nurses the level of treatment to be given to patients and the type of medicines to be given to patients, because, of course, those decisions will have a major impact on the cost of the care that they will be given. Since private insurance companies exist to maximise profits they will attempt to minimise the level of care that will be given to patients in hospitals, to our elderly and our sick. That is the grim reality of what is being legislated for.

The emergence of so-called hospital trusts is simply another step in the direction of privatisation. Let us consider the rampant move towards the privatisation of the National Health Service in Britain. Similar measures have been introduced there in recent decades. The National Health Service in Britain was an outstanding conquest made by the British working class and the British labour movement after the Second World War. It came about as a result of the specific weight in society and the outlook of the labour movement and it achieved a universal system of health care. It was a major concession wrung from capitalism in Britain for the benefit of ordinary working people. However, for decades now, in the hands of Tory governments on the one hand and right-wing Labour Party governments on the other, that system has been dismantled.

Professor Allyson Pollock is a wonderful defender and champion of public health care in Britain. She is based in Scotland. She has carried out coruscating analysis of what the policy of hospital trusts and the move towards control by private insurance companies is doing within the British health service. In The Guardiannewspaper on 14 January this year she sums up as follows:

Since the Health and Social Care Act removed the duty on the secretary of state to provide universal care, it is every hospital for itself, competing against each other in a market place; there is no planning, only forecasting for income and sales. But A&E is expensive and, like geriatric care and children's services, the price the government pays may not meet the costs. Hospitals would rather concentrate on niche markets like cancer, cardiac and elective care, especially if they can raise some private income at the same time. Markets don't like risk or uncertainty.

Is it not perfectly clear what is happening in the British National Health Service? That is precisely what this Government is legislating for; hospitals are being forced to become businesses.

The health service in this State has of course been historically under-funded, for decades, by comparison with similarly resourced countries within Europe. In the crisis within Irish capitalism and to a certain extent within international capitalism in the 1980s the health service here was ripped asunder. Thousands of beds were taken out of our hospitals and never replaced. Is it any wonder, therefore, that we have queues at our accident and emergency departments and waiting lists? To make matters worse, thousands of health care workers have been taken out of that system by this Government. Yet the Government expects that the health service can work. To add insult to the injury of the victims of austerity and the bailout of bankers and bondholders by this and the previous Government, the proposal provides for a new health tax that will be up to €1,600 per year for those who currently depend on their general taxation to pay for their health care.

The solution is to fund our health services by progressive taxation on wealth, corporations, etc., those who are not paying at present. The management of the hospital and health care system should be publicly funded, publicly owned and controlled democratically. We should bring the front-line workers, including doctors, nurses, auxiliary carers and cleaners, who have a crucial role in hospitals, to the heart of the management of the hospitals and health care services generally. In that way we will have a system and a health service that cares for sick and elderly people only on the basis that they are human beings in need of care rather than commodities, that is to say, the subject of profit-making by private millionaire- and billionaire-owned insurance companies and so on.

See this speech in context