Mr. John O'Dwyer:

Our annual report refers to consolidated accounts in 2012. We purchased a company, Home Care, which accounts for two thirds of the additional staff to which the Deputy referred. This is a consultant-led company which provides doctors and nurses to treat people in their homes rather than spend extra time in hospital. Up to 3,000 patients were treated in this way last year which reduces our claims costs and makes our proposition more affordable.

Several members asked about our recommendations on universal health insurance to the Department of Health.

Universal health insurance will be extremely difficult to implement but it is a correct strategy for the Government to have. It will take time but it does not mean we cannot take steps towards it. Perhaps we could look at UHI in some way for children or take the necessary steps by having a standard plan, as alluded to by Mr. Clancy. The VHI has no problem with a standard plan and standard set of benefits in the product and full cover for all the key treatments. Almost 40% of all our pay-out is for heart treatment, cancer and-or orthopaedic treatment. The key for us is that it must be fully supported by a 100% effective risk equalisation because as a country and Legislature, we have decided that community rating is the way we want our health insurance business to be run.

We have talked about whether to split up the VHI but the real issue here is the disproportionate amount of the elderly and sick the VHI has. If we have a community rated market, we need goalkeepers or referees for this thing we call risk equalisation. We need to have that in place to make absolutely sure that we have a fair and competitive health insurance market. The VHI does not have a bottomless pit to pay where we have ineffective competition like this. Distributing the sick and the elderly in a fair way across the market is the real challenge.