James Reilly (Dublin North, Fine Gael) | Oireachtas source

If the Chairman has the time, I am happy to have a long discussion with Deputy Kelleher on how this will operate. A main point that must be taken on board is the failure of insurers to date to address the underlying costs in the provision of private health care. It is possible. Everyone in this room has anecdotal evidence of people approaching them about procedures mentioned on their VHI bills that they did not have done. Clearly, our insurers need a more robust auditing system, particularly the VHI. That company is important. Although it only has 57% of the market, it is responsible for 80% of the pay-out. With a new chairman and CEO and with a clear direction from me, we have an opportunity to address the VHI's cost base in the provision of health care.

I want more robust auditing. It is astonishing that the VHI never had a clinical audit process whereby clinicians would challenge treating clinicians to explain why an unnecessary test was done and explain that the VHI would not pay for it and would impose a fine if it happened again. This will save a great deal of money.

We must also examine the manner in which we charge. Currently, we pay per diem instead of per procedure. One gentleman told me that it had cost him €8,000 to have an MRI because he spent several days waiting in hospital. The hospital would not release him. It told him that he would have the scan the next day, that there was an emergency, that he would be held onto for another night just in case, etc. We are all paying for this.

We must also conduct a proper analysis of what we are paying. Certain procedures used to take two hours and now take 20 minutes, yet we are remunerating the professionals at the same level.

We can make serious savings out of the €1.2 billion. An attack on the cost of private health care must be undertaken by the VHI. It is starting to do this. We can make health care more affordable by reducing the cost of the care.

Regarding the overall figure, an initial paper on universal health insurance will be published before the end of this year and a full White Paper will be published next year. The point is to have a debate and provide guidance on how to implement the multi-payer model. Such a model is our policy under the programme for Government. Competition brings better results for the client, in this case the patient, the user of the service.