Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I join in the welcome to Mr. Joyce and Mr. Sloyan. We in Sinn Féin want universal health care based on equal access for all and on the basis of need. We want that to be State-provided, funded by fair and general taxation and free at the point of delivery. That will require an increased contribution from the highest earners, as we have articulated time after time. We do not favour the insurance-based model of funding but if health insurance is to be the basis for funding, it is our contention that it should be a State insurance scheme. We base our views on the fact that the existing system is made up of a number of competing insurance entities, most if not all of whom are represented before this committee today, and that the competing private health insurance market satisfies itself regarding profitability and the interests of shareholders. We believe the State model provision will be focused on best patient care.

There are, as was said in Mr. Joyce's contribution and by the previous speaker, decreasing numbers of people with health insurance. We have rising premiums and more pressure on the public system. That has been referred to here in the past, and the Minister has also referred to it here in committee. Looking at the pillars of the Health Insurance Authority's responsibility under the Acts, I wonder if it has any function regarding the failure on the part of some of the competing private insurers to meet members' billings in a more expeditious way.

It is suggested to us as members that there is a significant hold-back on the part of some of the competing private insurers with the result that there is a negative impact regarding funding of the health services, with a deleterious impact on public health service provision.

It may not be within the witnesses' gift to comment on the various types of models that might present. It is the Government's stated intent to introduce a universal health care insurance model but I wonder about the real prospect of change. We have seen the first element of what the Minister had announced, that is, the proposed extension of free general practitioner care, postponed. The programme for Government promised that the White Paper on financing universal health insurance would be presented early in the Government's first term. I recall asking the Minister on the floor of the Dáil what he understood "the first term" to mean and he said it meant the entirety of the 31st Dáil - that is, five years. He sounded very hopeful that there would be a second.