Joan Collins (Dublin South Central, Independent) | Oireachtas source

Deputy Brassil made many of the points I intended to make. I appreciate that the representatives from the PHA have come before us. Mr. Fitzgerald stated that 5% profit has to be made to reinvest in infrastructure in the hospitals. How much goes to shareholders? Is that information commercially sensitive? How much goes to marketing for the hospitals as well? They are important parts of how a health service is managed and how the money could be reinvested in the public sector.

Mr. Fitzgerald also referred to accountability and how he had to make himself accountable to his board. Would something similar have applied in his then role as a manager in the public sector? Deputy Brassil also made the point that this committee is examining ways to bring in a health service that is based on need and not on the ability to pay, free at the point of entry and accessible to all.

In his opening statement Mr. Simon Nugent stated, "One welcome innovation has been the reintroduction of the National Treatment Purchase Fund and, while the resources available to be spent in 2017 are modest, PHA members will be able to respond and provide treatment to some of the longest waiting patients on public lists over the coming months". That is a failure in the public health service being welcomed by the private hospital services because it will generate income from the National Treatment Purchase Fund and more patients.

I do not subscribe to private health insurance so I cannot walk up to the door of a private hospital and say that I need a procedure in a private hospital. That is where the ideological debate breaks down. We are looking at how patients are dealt with properly, efficiently and it has to be an efficient system, a system where staff are able to work. The public health service provided such a service for a long time in the general hospitals. There was movement within the structures, people got promoted and people followed the medicine they were interested in.

In 1947 a White Paper was initiated by the Government to look at a national health service similar to the National Health Service established by Bevan and also to examine social welfare payments. It was buried because the then Department of Finance did not want it. There were interested parties which did not want that to happen. With the crisis in the public health service, people want to see a proper public health service that people can access without the need for significant resources or private health insurance.

In his concluding remarks, Mr. Nugent recommends that the committee consider establishing a task force to explore innovative, cost effective private sector capacity utilisation and so on. However, if we want to provide a public service that is different from the private hospital model, what attitude would he take to such a service?