Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

I wish to refer briefly to the point just mentioned by Deputy Reilly. The Minister was almost boastful in her contribution in relation to the numbers of people who are now signed on to the registers of VHI, Vivas, QUINN-Healthcare, etc. This is nothing to be proud of. When one gets to the bottom line with people, one will find that a huge swathe of those people, particularly those new people who have signed on in recent years, are doing it because they have lost faith in the public system. They see public moneys being diverted away from the public system. They have seen the reality of languishing on waiting lists and the difficulty of even getting on a waiting list. They do not want that for themselves or their children and that is very understandable.

Many are actually suffering the loss of something else important in their lives in order that they can have the assurance of that in the event of a need presenting. Many of these people would not see themselves as a part of a new poor in Ireland. The truth of the matter is that a greater number of them are obviously without medical card qualification. There is a body of people with medical cards and there are those who are much better off in society and for whom the matter of paying for access to health care is something they can take in their stride. There is then a huge group in the middle, the greater number of them couples, either married or in relationships with children, with both parents working to ensure they can cover the costs of the provision of a home and the needs of children in terms of child care and everything else. What they have got on top of it all is the forced reality of having to take out health insurance for peace of mind. I assure the Minister that a significant body of those people would never have taken that as a first course of choice.

The Minister's colleague, the Tánaiste and Minister for Finance, stood here on 5 December and announced the increased spending allocation for her Department for the coming year. People talk about the €16 billion allocated to the health budget. The reality is that the people are paying many millions more again. What is the true cost of the provision of health care in this State today? One must do the sums. The cost involves not only the monies expended through the Exchequer but what people also pay apart from their tax contributions that make up the Exchequer figures. They are also paying on the double through private health insurance, which is a fact of life. If one adds to that those paying cash for the direct delivery of services from their GP, access to medicine and all the rest, the total sum is huge.

I do not believe that sum has ever been computed because no-one has taken the time to do so. The Minister would be shocked by what it would be possible to do in the delivery of health care with the sum that actually comes from the pockets of our people, either through the Exchequer or directly into the health system through health insurance and all the rest.

If we were to have a state-of-the-art public health system in which every citizen would have confidence, it would cost a great number of people less than is currently the case. That is achievable and there are examples of this around the world that can be emulated. One of the real lessons that Professor Tom Keane can perhaps bring to his two-year tenure in this State is not any innovation, because he is on contract to implement the Minister's programme for the delivery of cancer care services, but that hopefully over the period of time some of the reality of the experience he has known in British Columbia and Canada might rub off on the Minister and others in the Department of Health and Children.

The lessons need to be learned. We need to get rid of the 20% allocation and the piggy-backing of private care on the public health system, but not in the way the Minister is going about it. The correct steps are for a universal system, free at the point of delivery for every citizen and on the basis of need alone. That is what we should be working towards and what every party in this House should be committed to achieving.

Our citizens, born equal, deserve equal treatment and respect throughout every stage of life until the end of life itself. I believe in nothing less.

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