Jan O'Sullivan (Limerick East, Labour)

I commend the Fine Gael party and my colleague, Deputy James Reilly, on bringing forward this motion, which gives us an opportunity to address in particular the issues around private health insurance but also the broader issues in regard to health. I apologise that I had to be absent for part of the beginning of the debate.

I will begin by touching on a point which I may return to later, which is dealt with as a first point in both the motion and the Government amendment. I share Deputy O'Mahony's amazement that the Government "welcomes the action by Government to reduce unacceptable waiting times for patients in emergency departments" and the claim "that every medical patient presenting to hospital will be seen by a senior medical doctor within one hour". That is fantasy land. What world is the Government living in if it thinks this is what is happening in our hospitals?

I have spoken to people who have been not just hours, but days waiting in emergency departments over the Christmas period trying to get access to some kind of treatment and care in highly unsafe and crowded conditions. We discussed this issue during Question Time last week. I find it astonishing that the Government is so distanced from reality as to think it can get away with using that kind of wording in an amendment to a Dáil motion. If the backbenchers read that, they will be inclined to support the Opposition because they will believe the Minister is living in a fantasy world.

Some 569 people were on trolleys in one day, with 1,500 beds closed and people occupying acute beds who should be out in the community. It is like groundhog day from the time the Minister said this was a national emergency back in 2006. That is the real world. This idea people are being seen within one hour by a senior medical doctor is some kind of dream the Minister must have had last night before she put down the wording of the amendment. It is certainly not reflective of what is happening in hospitals.

There is a much broader issue involved than merely the increase in VHI charges. Simply laying the blame on the VHI and advising customers to shop around and consult the Health Insurance Authority website is an inadequate response to what has happened. The current situation is evidence that the market is not working. Most people who take out private health insurance do so because they are fearful of the situation in the public health system, with 569 people on trolleys in accident and emergency departments, long waiting times for procedures and so on. People take out private insurance because the public system is not properly supported and funded in such a way that there is equality of access. The basic problem is that we do not have a one-tier system. People opt for insurance in order to jump the queue ahead of those who cannot afford to do so.

However, increasing numbers of people are beginning to question why they are paying so much for health insurance and what they are getting in return. They are asking whether they are not, as a citizen of this country, entitled to hospital treatment. However, while some are cancelling their insurance because it does not offer value for money, there are many others for whom it is simply no longer affordable. It is a much more broad-ranging issue than merely balancing the various health insurers and ensuring a more even playing field. Which is not to say that this must not be done, and I strongly support the section of the Fine Gael motion which calls for the risk equalisation legislation to be introduced. That has not been done in accordance with the timeframe the Minister announced when she introduced the Health Insurance (Miscellaneous Provisions) Bill 2008 in the wake of the Supreme Court decision in July 2008. We have had a crude interim measure for several years-----

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