Liz McManus (Wicklow, Labour)

Does the Minister accept that what she is doing is deepening the divide between public and private patients within the health service? This will surely raise questions for her with regard to entitlement. She must be aware that everybody in the country, including the Minister, is entitled to access public care. Is she being naive in thinking that by building private hospitals on public land, private patients will automatically go to the private hospital despite being entitled to go to a public hospital? Private patients will presumably continue to exercise this entitlement. Does the Minister intend to take away this entitlement from people with current health insurance? This would be a major action and the Minister should comment on it.

With regard to capacity building in the public hospital sector, does the Minister recognise the financial loss in providing generous tax breaks to the private and for-profit sector? This is essentially a new player in the provision of Irish health services. A generous attitude is being taken by the Minister, as well as the Minister for Finance, Deputy Cowen, in this regard. This is a loss to capacity building where it is needed most, in the public hospital sector.

Does the Minister accept that the sector is not competitive? The Minister has the idea that these hospitals will compete, but there will not be competition between the two unless a system similar to that of the US is implemented. Private hospitals there must provide accident and emergency services. How can a public hospital compete with a private hospital when the public hospital is required to provide accident and emergency services and correctly does so for everyone, regardless of whether a patient has health insurance?

I have a question regarding the loss to acute public hospitals. These are currently able to garner some of their income from private patients so will the shortfall be made up? How will the Minister prevent cherry-picking by the private hospital sector, which will be looking for profit? Profit and making money for investors will be the motive and nobody can complain about it. How will the Minister prevent a scenario where hospitals carry out many procedures that are not a high priority but are lucrative? Meanwhile, public patients will attempt to cope and access care in a public hospital sector that is deprived of necessary funding and incapable of competing with private hospitals that have tax breaks and do not have a requirement to provide accident and emergency services. There is not a level playing field, although this is an argument put forward by the Minister.

The Minister should consider what she is doing because this is ultimately not the way to go. This process will create further division and inefficiencies with regard to value for money in the health service.

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