Liz McManus (Wicklow, Labour)

The Government, particularly the Minister for Finance, has sought to convey the impression that it has moved to close off tax schemes as a result of a review but that is not true. Final closing dates have been set for many of the property-based schemes but such commitments were made previously and reasons were always found later to grant a further extension. The Government's characteristic hallmark is the broken promise. It does not have credibility regarding these open-ended commitments. It has also sought to convey the impression that it was not the case that rich people made a killing out of the generous tax breaks, but the Minister for Finance was wrong in making this case in his contribution. Eleven millionaires pay no tax while hundreds of people earning more than €200,000 pay minimal tax because of these schemes.

The Bill contains a list of schemes that will be restricted but the list is not exhaustive. In other words, other schemes, most notably that relating to private medical facilities, will not be subject to the proposed restriction. Investors will flood towards the medical facilities and a wall of money will fall into the laps of hospital promoters, the no tax millionaires will return and a fundamentally unjust and unsound health policy will be stitched into the fabric of Irish life. When the Minister for Health and Children who is not able to grasp the most basic elements of good health policy announced her proposals on private hospitals, one developer commented, "It is the answer to our prayers; we couldn't have written it better ourselves."

We have a two-tier health service where the experience of the public patient and the private patient is markedly different. The promotion of for profit hospitals is being introduced, encouraged and fuelled by Government policy. No report on the primary care, acute hospital or mental health sectors has argued for this change. That is not the way experts in health policy view the needs of the health service and patients, but because the Ministers for Health and Children and Finance have tunnel vision, a new element is being introduced, which will siphon off important resources into areas of less need.

For profit private hospitals will be established on the grounds of public hospitals. This is reintroduction of the old dispensary model where if one is poor, one is directed into an inadequate substandard dispensary in which doctors are not encouraged to work within the field and best practice does not prevail but where if one is privately insured, one will be directed into the private hospital where, very often, if the American experience is anything to learn from, procedures will be carried out which are not necessary or a priority but which benefit hospital promoters who are in it to make money.

We cannot afford to adopt this approach in our health service. It should be recognised that the distortional effect of this policy will deepen the divide within the health service and move even primary care away from the integrated approach that has developed over years and spearheaded by a Fianna Fáil Minister, Erskine Childers. It took a great deal of courage and legislative change to introduce an integrated service at primary level. A Progressive Democrats Minister for Health and Children, assisted by a Fianna Fáil Minister for Finance, is ensuring the old divide will be deepened and strengthened at a time when we have the capacity to move in a much better direction to meet the needs of patients.

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