Dara Calleary (Mayo, Fianna Fail) | Oireachtas source

Gabhaim buíochas leis mo chomhleachaí, an Teachta Kelleher, as ucht an seans an fadhb dáirire atá againn le árachas sláinte a phlé.

We all accept it is a serious problem when 140,000 subscribers have left the private insurance market in two years. These 140,000 will now depend on the public hospital system to look after them.

In January 2011, Deputy Reilly, speaking about increased health insurance premia, stated it is the last straw for many and that many who have been holding on have given up their insurance as a result of these proposed increases, the consequences of which will be more pressure on our public hospital system. No doubt this has been the effect. In his tenure as Minister for Health, there have been 140,000 additions as a consequence of such increases. In March 2012, the Minister defends that by stating that is the way it goes, even through he has a chance, as Minister, to influence it through legislation. When he introduced legislation, it achieved the opposite of what he intended. It has added to the cost base and to the cost of premiums of many of the companies. In fact, it has also resulted in a reduction in the benefits of many of the packages. That is the Minister's track record after two years. In fairness, the Minister of State, Deputy Alex White, is only in the Department a few months and I am happy to give him much more time to try to achieve something on it.

There is a serious problem in the market. Initially, we were told that competition would be the answer to the problem and the introduction of new market entrants would sort VHI out. In 2011, VHI's market share was still 57%. In four years, it has only fallen from 66% to 57%. It is still the dominant player in the market. It is still the player that is being subsidised by the private players in terms of many of its plans and we must look at its modus operandi.

When one compares the cost model of VHI, in terms of its running costs as opposed to the profile of its customer, against those other competitors it is completely out of sinc. Its running costs are considerable higher than those of its competitors and those running costs are passed on in the premia increases to those of us who are VHI customers. VHI is using its loyalty within the Irish market to pay off those cost increases and therefore is putting pressure on the private operators in order to do that.

Many Members referred to the flight from the insurance market of younger subscribers, in particular, young families, and specific attention needs to be paid to that. Why is it that those with no children are less likely to use the system and are not even considering taking out insurance? God forbid if they need the system, they will have to depend on an overstretched public system. It is because there are few incentives for them. The Government, through the legislation passed before Christmas, through extra levies, is adding to the cost for children. It has a chance of doing something on this, by stating to families that in one area the Government can control - the cost of health insurance through levies - it will reduce the levy on children or get rid of it altogether when it comes up for payment in a few weeks time as a signal of the Government's interest in their position as families in terms of the running of their households and as a statement that the Government wants people to try to have health insurance. Instead, the advice coming from the Government benches is to shop around. Like Marie Antoinette, those who sit on the benches opposite suggest those who shop around will find it.

As, in fairness, Deputy Buttimer stated, it is difficult to shop around when there are tens of plans available. It is utterly confusing and nobody seems in a position to explain to the consumer what is in certain plans and not in others. Instead of telling consumers to shop around, let us work with the market and tell insurers to simplify their offer, take away all the frills and elements that confuse the marketing of the offer, and give consumers direct information. They should do consumers that favour alone. That is something that has not properly happened. There is still this mirage of plans with which consumers are utterly confused. Unfortunately, in many cases it is only when subscribers go to use their plan that they realise its deficiencies. That also needs to be addressed.

An issue that applies with all of the companies is the delay in paying hospitals for services that have been provided. At every HSE quarter meeting, it is pointed out that there is money outstanding from various insurance companies to hospitals and the HSE generally for services that were provided, and it tends to be a substantial sum. In HSE west, at one stage the sum was in the teens in terms of millions of euro, much of which dated back a long time. That was due to disputes over the filling of forms because consultants would not fill out forms properly, and that is not right. It means that hospital beds had to be closed and services had to be withdrawn from companies which have the money and will not pay it. That is an issue these companies need to address as a matter of urgency. The Department needs to flex its muscle in this regard and not have a situation, as is the case every year, that when we come into August and September cuts must be made to the health budget.

Some of those cuts happen because some of these large companies that have the money will not pay the HSE or pay the various hospitals on time. It is March and we can stop that from happening now. That is one easy way to resolve the challenges in the health budget and there are not too many other ways.

The tenor of debate from the Government side has been phenomenal. There is an unbelievable loyalty in Fine Gael to the Minister, Deputy Reilly. One will not see that in the O2 tonight with all those screaming fans of One Direction. For Fine Gael backbenchers he is like the Niall Horan of Fine Gael. They speak of all the reform he has introduced in the past two years. I remember being here in 2008 when the then Minister for Health and Children, Ms Harney, introduced the reforms that have revolutionised cancer treatment and revolutionised the outcomes for those who are unfortunately suffering from cancer. I remember the Minister, Deputy Reilly, leading the charge against those reforms because it suited him and it suited Fine Gael in Sligo, Mayo, Galway, Cavan and Monaghan to lead the charge against those reforms - reforms which he has now championed. We now have to listen particularly to the Fine Gael Deputies praising him for that - the Labour Deputies are slightly more circumspect of the Minister, Deputy Reilly, which, given their experience with him, is to be understood.

These are reforms he bitterly opposed and from the back of every truck during 2011 he told every community he would deliver and subsequently he has gone away. I will not take a lecture on the lack of reform during our time in government from Deputies so devoted to a Minister who opposed every one of those reforms and got votes on the back of opposing those reforms. Now we are all supposed to bow down and face towards north County Dublin - or is it Tipperary, I get confused - and pray towards him and give thanks to God for this maestro who is Minister for Health. The 140,000 people who have given up on the Minister's health insurance policies do not even begin to add up to the number of people who have given up in other areas of health. Nobody should expect us to accept him as a champion of reform.

See this speech in context