Brian Cowen (Laois-Offaly, Fianna Fail)

It is not true that investment is going into the private sector while the public health sector gets nothing. There is historically unprecedented capital investment going into the public health sector since 1997. Whatever people may suggest about the past, this Administration has arranged for the largest amount of public capital and current investment into the health sector in the history of the State.

The Deputy asked my view on tax reliefs. I will await the outcome of the review so that I will be informed on our current position and then I will decide with colleagues where we go from here, what our priorities should be and what role, if any, private sector investment should play in addition to the role it already plays.

I am anxious to see the maximum possible level of investment in the health service from all sources. I am sure if the Exchequer was limitless, it would put more into the service. We should all consider the availability of access to capital, public and private, for the public good of improving our health service. We should also take into account all aspects of such a proposal and consider all of this carefully. In terms of it being a concept, the idea of private finance initiatives is something in which the new Labour Government has been involved in the United Kingdom, whether in education, health or elsewhere.

We must ensure we do not close off opportunities for further improving the standards of care that can be available to all our patients, including public patients, by deciding that only public capital should be the means by which we can improve services. We should be open to considering what role, if any, private capital may play. We must look at the pros and cons and see what issues arise and how we can deal with them and consider whether we would like to see a tax to such a proposal. My attitude, therefore, is open. I am prepared to consider these matters on the basis of any proposal that comes before me and in the context of the current review.

The issue of private sector investment in nursing homes is separate. I do not have detailed information here and cannot tell the Deputy what tax reliefs related to that nursing home in Swords. To make a general point, I recall from Finance Bill discussions that the availability of tax relief for private nursing home care provided in the region of 11,000, 11,500 or possibly 13,000 more places in the nursing home sector in Ireland since the scheme came into being. These places were in addition to those extra services provided by the public capital programme for the elderly through nursing home care and community nursing units and those created by us having to improve the existing level of care that was available in public facilities. We may not have been happy with these public facilities but the lack was there because we did not have the available resources previously.

This is an area where we need to apply our minds. The point is that the question of resources, improved capital and improved current funding must be allied to a reorganisation of delivery of the services, whether care for the elderly, acute hospital care or community services. Our social partnership programmes leave no doubt that we must all commit ourselves to finding a better means by which we can improve the service delivery mechanism of these services, given the level of resources being applied. Quite apart from the private sector investment into which the Deputy is inquiring, public sector capital and current investment has been unprecedented in the history of the State in recent years.

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