Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

The Minister set out to attempt to rubbish the point that the so-called reform strategy and what the Minister envisages in terms of universal health insurance as the basis of the delivery of same into the future is based on competing private health insurance companies, yet he concludes by lauding and applauding that very approach. His conclusion is so contradictory from what he said at the outset that it does not stand up. The Minister cannot have it both ways.

I indicated on Committee Stage that we are both committed to universal access on the basis of need. This, however, is not the basis on which to guarantee that. There are no guarantees. The model on which the Minister is basing so much of his intent, and which I must say from the very outset was referred to consistently by the Minister and others, is the model operated in the Netherlands, and that has been shown on more careful scrutiny to be anything but what it purports to be or, perhaps, what it set out to be.

There is serious concern and a lack of confidence about the approach. The Minister has still failed to produce a White Paper. We have no outline of a plan, although we have the Minister's continued and repeated statements that he is examining this and examining that. He is looking everywhere but he is not coming forward with the outline of how this will unfold, and that is the detail people want.

When I made the point about private insurance companies being given too great a role - not the determination of it in total, but too great a role - and I believe that is what they will have, in determining the level of basic health care services available to citizens, the Minister responded that the Health Insurance Authority would determine that.

With all respect the Health Insurance Authority is a quango of little proven worth. That was emphasised and underlined by its representatives' recent appearance before the Oireachtas Joint Committee on Health and Children.

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