Joan Burton (Dublin West, Labour)

I move amendment No. 27:

In page 10, subsection (4), line 10, after "appropriate" to insert the following:

"with a view to promoting the opportunity for agreement where with any body which in the opinion of the Minister for Health and Children is representative of the health professionals concerned, in relation to the terms of the regulation to be made under subsection (1)".

Some of this ground has been covered in our earlier discussions. At present it costs between €50 and €60 to visit a GP privately. The preamble to the Bill states that professional medical and legal fees will decrease by 8%. In an economy which is experiencing deflation, professional fees are relatively high, particularly for ordinary people. The majority of public servants who will pay this levy do not qualify for medical cards. The Government's proposal to reduce professional fees is a quid pro quo but I am not convinced about how or when this will happen. If a person visits a solicitor next week to draw up a will, can he or she ask that the fee be reduced by 8%? That is what this means to the person in the street. This provision does not seek to provide for that.

A complication arises in section 9 in regard to professional bodies. The various associations of professionals, particularly in the health services, have a long-standing demand to be recognised for the purpose of negotiating collectively on behalf of their members. The approach of the Minister for Health and Children and the HSE has consistently been to deny outright or to limit that negotiating right in a parallel trade union situation. The advice from the Competition Authority has been that as these professionals are in business in their own right, negotiating therefore constitutes a type of collaboration which amounts in effect to a cartel to fix prices. The Competition Authority objects to professional bodies having negotiating rights in respect of general issues affecting their members.

Each time the Health Service Executive or other body is required to engage in negotiations, they reach for lawyers and the Competition Authority who tell them they cannot hold discussions as they would be engaging in cartel practises. The biggest cartel and oligarchs in this country are the banks who have made billions. It is pity we do not know where most of this money is or if it is gone down the drain, the hole we are now trying to plug. The Competition Authority never had a go at any of them. In fact, one gets the impression that people such as the Minister for Health and Children were more often wined and dined by people from the banks.

I recall asking the Regulator, in regard to various shareholdings on contracts for difference in respect of Anglo Irish Bank in which he was not able to take an interest, if he would be interested in such matters as a Russian oligarch sailing up the Liffey and announcing his intention to take over the Irish banks. He looked across the table at me but did not respond. We are in difficult territory. I am sure the Minister will be delighted to hear that people are utterly confused.

The Minister is suggesting there will be a reduction in professional fees and has cited in particular medical and legal fees, namely, doctors, dentists, pharmacists, physiotherapists and, on the legal side, presumably, solicitors and barristers but he has not told us how this will be done. In addition, people in these professions are represented by long-standing professional bodies who negotiate on a quasi trade union basis to set fees and conditions. Also, there are in all of these professions weaker and younger members who do not have the know-how or strength of the more experienced providers at the top who can and do charge high fees.

We are being left to the mercy of the Minister for Health and Children who is being given sweeping powers under sections 9 and 10, which I presume is the Minister's intention. However, a question arises in regard to whether they will simply facilitate a greater bureaucratic whip hand for the Department of Health and Children and the Health Service Executive and, similarly, the Department of Justice, Equality and Law Reform which, I presume, deals with fees for lawyers and barristers?

See this speech in context