Trevor Sargent (Dublin North, Green Party)

I pass on apologies from Deputy Gormley, our health spokesperson, who has to be in Dublin Castle to meet Commissioner Barroso. I have spoken to him and discussed some of the experience he has had on the Joint Committee on Health and Children which he has asked me to relate. The Green Party believes in community rating and accepts the advice of the regulatory body on risk equalisation, which is supported in name by Government but we have yet to see the action to give effect to that. I heard the Tánaiste relate that she regarded as a good phenomenon that more people were now reliant on private health insurance but I argue that indicates that more people are extremely nervous about depending on the public health system. It indicates the public health system does not meet the standard people expect it to deliver. There is also a growing fear that people will require the services of hospitals and the health system more than they would want and I accept that nobody wants to go to hospital. People read about and experience an increasing incidence of asthma, cancer or other conditions or diseases and they may need to make provision for hospitalisation and health care more than they would otherwise be likely to do.

The problem of a two-tier health system has not been addressed by the Government. The gap is growing between the reliance on private health insurance and the public health system. We need to examine the rising cost of the health insurance premiums. It is often mentioned that medical inflation is some type of runaway phenomenon that is a creature unto itself but that must be addressed. The Tánaiste as Minister for Health and Children has far wider responsibilities than the health insurance companies, the role of which essentially is to service the needs of people who are sick.

We need to see about other factors which may be affecting the cost of the provision of health services, not least health insurance companies. I would instance asthma, for example. Dietary related issues have been mentioned in this House, but have not been given sufficient attention. Obesity, in particular, is one matter which is getting a considerable amount of debate outside this House. Such conditions might be addressed from a multi-disciplinary perspective with a possible role for interdepartmental action. We have seen the difficulties experienced in the Department of Education and Science as regards the provision of physical education facilities, the lack of playgrounds, skate parks etc., which encroached on the responsibilities of other Departments. Basically, the problems most often referred to as obesogenic — environmental problems — will impact on the cost of health premiums because of the demand for health care services.

A far more holistic view needs to be taken as regards the cost of health insurance so that effectively there is not such a burden of cost on the individual citizen, regardless of whether they are taxpayers, when it comes to health matters. I ask the Minister, on the basis that we are accepting risk equalisation, to proceed quickly to ensure that the fund is in place and that there will be practical implementation of the legislation as the current frustrating delay is causing more and more people to find refuge in health insurance. This is because they do not feel confident that either the Government or the public health sector are able to address their needs. Those needs are perceived to be growing, particularly for people who are in need of hospitalisation. Those people are very nervous that if they do not have private health insurance they will be much the poorer in terms of their health as they wait for services which they are entitled to as citizens. They are promised such services in theory, but in practice those promises are not met.

While I welcome this debate and appreciate that the Tánaiste has taken it at short notice, I ask that we proceed very quickly to ensure that risk equalisation becomes a practical reality.

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