John Crown (Independent)
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It is very difficult not to be cynical about the process of politics. I add my support to Senator van Turnhout's comments on the amendment we tabled to the general practitioners Bill yesterday. This has been a case of misinformation, rather than a misunderstanding. It is being suggested to the press that our attempt to insert a rational and limited amendment in the Bill, which would have protected general practitioners who wish to whistleblow or point out deficiencies in the health service from being victimised, is being used by others as an opportunity to delay the Bill and painted as a reason why parents will be forced to pay for GP care for their children for a further six months. The Minister and Minister of State know that if they were to accept the amendment, the legislation could be passed by the Dáil and signed by Uachtarán na hÉireann before the summer.

To return to the specific questions, while I am very troubled by the position with respect to many aspects of the health service, the position in trauma continues to be extremely unsatisfactory. We do not have one centre in Dublin that can provide comprehensive trauma care to somebody who has a complex set of injuries. The services are still fragmented, with neurosurgery in one centre and burns care in another. A limited number of centres can deal with a penetrating cardiac injury, which is, thankfully, an uncommon type of injury.

On a more basic level, it is still the common experience of people who work on the front line of the health service, including in fine university hospitals that may lack some aspect of the specialist care that an individual patient needs, that the barrier to getting a trauma patient moved from one hospital to another can sometimes result in an unconscionable and life-threatening delay. Without getting personal about it, I have encountered cases involving individuals who I have no doubt would have lived if an ambulance had brought them to a hospital that could have provided the specialist care they needed. It is critically important to tackle the hospital politics involved and to understand that it may be logical to have only one or two centres to which trauma cases are brought in the capital city. We also need to build up trauma services in Cork, Galway and local centres to an appropriate level.

I also tabled a question on the possibility of allowing private insurance premiums to be weighted, specifically to allow people who do not smoke to apply for a discount in their private health insurance. This is not an attempt to thwart community rating, redistribute resources or punish people. It is a specific measure to provide an additional incentive to people to give up a habit that is very bad for them. While the saving to the system would be relatively small, it would give individual patients one more reason to give up smoking. In addition, the measure would not be contrary to the spirit of community rating. A 65 year old cannot choose not to be 65 years old and a person born with an illness or malformation cannot choose not to have a pre-existing illness or congenital malformation. However, one can, subject to the powerful influence of addiction, choose to be either a smoker or non-smoker. There is no reason to believe this proposal would somehow create a fundamental chink in the armour of community rating, which is an approach I hold dear. If we eventually move to a model of social, not-for-profit insurance for the entire population, with everyone playing on a single, level playing field, as I hope we will, I will fight for community rating with my last breath. Rather than thwart community rating, the proposed measure would encourage people to make positive and healthy lifestyle choices.

I wish the Minister well in the coming days and hope things do not work out in the manner that is being played out in the newspapers.