Mary Harney (Dublin Mid West, Progressive Democrats)

In regard to comparisons with the Dutch health care model, a visit to a general practitioner in the Netherlands costs €24.80 whereas it would cost €50 or more in this city. We should compare like with like. Hospitals and insurers have closed or consolidated with the result that prices have risen very rapidly. This is not a perfect world.

Yesterday I discussed health reform in the United States with a doctor and US Congressman who was here as part of a visiting delegation. These reforms aim to move away from procedure based medicine because of the rising costs involved. I have not met any health Minister in the developed world who is not concerned about costs. Equally, we have one of the best health care systems in the world, regardless of how often the Deputy rubbishes it. Significant advances have been made in cancer and cardiac care, infant mortality and life expectancy. We are not perfect but we are improving at a fast rate. That is nowhere more evident than in the area of cancer.

The scheme of risk equalisation was introduced by the former Ministers for Health, Deputies Howlin and Noonan. It was a good idea but, unfortunately, it has been litigated out of existence and was eventually struck down by the Supreme Court. It will take some time to go back to the drawing board and I do not doubt that we will again face litigation. In the meantime, older people will not be able to afford insurance.

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