Maureen O'Sullivan (Dublin Central, Independent)

It is rather strange to discuss private health insurance. Whether the legislation is necessary is one thing but a great deal more is needed in our health service. Many people have believed in and purchased private health insurance. I did too, many years ago. One sometimes asks oneself why one did so. It has nothing to do with our health system or the quality of our health service but with accessing that system and having faith in being able to access it. That is the reason so many people have opted for private insurance. The aim is to access treatment speedily.

According to the Minister's speech last night, almost half the population, 47.5%, have private health insurance in one form or another through inpatient plans. Of course, the VHI has the bulk of this business. The numbers are decreasing but it is still a significant amount. In 2010, €1.9 billion was spent on premia, a 19% increase on the 2008 figure. There is still plenty of money about.

On the one hand, private health insurance takes pressure off the public system, but it is based on unfairness and the fact that payment will secure quicker access. Payment will get the scan and quicker access to the consultant and secure the private or semi-private room. I cannot but be aware of the system in the private hospitals. When one gets a time for an appointment, it takes place at that time and when one gets a date for a procedure, nine out of ten times it will happen on that date. Patients generally do not have to go through our chaotic accident and emergency system unless there is an emergency. Now, money can pay for the various clinics catering for minor ailments, broken limbs and so forth, and the waiting time is minimal.

I do not understand why our public system cannot provide the same efficient service. We have excellent doctors, nurses and other personnel. There have been some very good developments with the breast screening and cancer services, but there are major problems. In 2004 the then Minister for Health stated, "The one thing I want for the country I love is to have a health service that is accessible to every citizen, regardless of his or her wealth". That Government had seven further years in office and I do not believe progress was made in that regard.

We have a two tier health service, with access based on ability to pay rather than need. We need a fair and equitable health system. The programme for Government states that this Government is the first in the history of the State that is committed to developing a universal single tier health service, which guarantees access to medical care based on need, not income. Within the programme there are ambitious plans to radically change the Irish health system and to provide for equal access, universal health insurance, which will be compulsory whether it is with private or public insurance.

That is the plan but in the meantime the reality is very different. There is immense pressure on the public health system. We are aware of the waiting lists and yesterday the Minister of State and I attended the briefing on the mental health service, so we know what is happening in that area. People are dying unnecessarily. I pay my private health insurance and because I am healthy, thankfully, and have not needed to use it more than once or twice, my good health is benefitting those in the private system. However, it is not benefitting people generally. The system must be more equitable.

The Bill seeks to regulate the health insurance market and the area of risk equalisation. The Supreme Court judgment found that risk equalisation was not maintaining what was termed "the common good". I believe the common good, in broad terms, means having a health system whose core principle is the common good of all, not just the good of those who have the ability to pay for it. We need a fair and equitable health system, with equal access available to everybody and not based on ability to pay. The Bill refers to all consumers, without differentiation being made in respect of age and health status. There should be no differentiation within the health system. We must look to the common good for all of our society.

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