Bernard Durkan (Kildare North, Fine Gael)

I entirely agree with the sentiments expressed by my colleague, Deputy White. When discussing health insurance and health services in general, we should bear in mind that every single person in this country will have to access the health sector in some form or other during the course of his or her lifetime, either on the way in or the way out. It is an issue that affects everybody to a greater or lesser extent. All of the young people in the Gallery today either have been or will be beneficiaries of the health service, and that must be paid for.

In recent years we have seen a shift away from the expectation that people can rely on the public health service to provide for their needs, with an alternative to be provided by the private sector. Unfortunately, the two have crossed over each other and there is a severe degree of duplication. I spoke on this issue back in the mid-1990s when the whole debate emerged about competition in the private health insurance sector and the sharing of the burden by new entrants. We discussed at length the need for new entrants to recognise that everybody must carry a fair share of the burden, both new providers and those already operating in the market. Unfortunately, that did not happen despite the existence of the sticking plaster legislation which we are proposing to extend.

I compliment the Minister of State, Deputy Kathleen Lynch, on her opening contribution to this debate last night. It offered an excellent outline of the current system, the difficulties facing it and the need to address those issues as a matter of urgency. Countless people throughout this country have made health insurance contributions over their lifetime, some of whom have been unfortunate enough to have to draw on the services provided. Many VHI customers are now old, but they were not always so. They made their contributions throughout the period in their life when it was expected that they would have little call on the system. They made their payments consistently and it was a great burden to do so at times of very high taxation.

There are issues of serious concern in regard to the current dual system of provision. For example, there was and is the suggestion that, in some cases, private health care is soaking up a disproportionate amount of available resources. If that is allowed to continue, not only will we have a duplicate system, but also a hugely expensive one across the board. If services can be provided, as has been alleged, at a much more competitive rate in other European countries, then something is wrong. Why are we unique? We are not so special that we should be treated differently from everybody else. It is well known that there are health systems in other European countries and beyond which work effectively and competitively and are very responsive to the needs of their population. I do not see any reason that we, at this stage of our development, cannot provide a service equal to any of them.

We have a year or two to contemplate what should be done. There is one certainty in this; if we do not eliminate duplication, overlap and double payment by the consumer into the system, we are doomed. The universal health insurance system, as proposed by Government, is the right approach. Everybody is entitled to a basic level of cover and a basic level of service thereafter. If that provision is not in place, only the people who can afford it will be sure of obtaining service. That is not acceptable in a republic. We are still in control of our own destiny to some extent. The part which nobody can explain is that we were able to provide all of these services many years ago. Despite the public and private contributions made over many years and the fact that we allegedly have a sophisticated health system, we cannot provide the same level of response we were able to provide 25 or 30 years ago. Some of us might know the reason for that, and it is being worked on by the Government.

I fully agree with Deputy White that it is deeply sad that Fianna Fáil, a party which represented a broad spectrum of society for many years, failed to exert its representational authority by asserting to its erstwhile colleagues in government that there was an obligation to provide for all of the people in so far as possible from the resources available to us. That was never done and I cannot understand why. Fianna Fáil Members, of all people, should have understood the importance of doing so. I welcome Fianna Fáil's return to this debate. It is hugely important for the benefit of this country and its people. I support the proposal outlined in the Bill.

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