John Browne (Wexford, Fianna Fail) | Oireachtas source

I welcome the opportunity to speak on the Health (Amendment) Bill 2013 [Seanad]. Our party will find it very difficult to support this legislation unless major changes are made by the Minister on Committee Stage. The proposal to charge all private patients in public hospitals will increase health insurance premiums. This will add to Government costs as more people will give up private health insurance thereby putting more pressure on the public health system. Many speakers have outlined that situation.

The Government's policy is to introduce a system of universal health insurance commencing in 2016, although there is not much sign of that at the moment. The Bill seeks to give effect to budget 2013 measures, including charging all private patients in public hospitals, increasing the daily charge for public inpatient services in acute hospitals from €75 to €80, increasing the asset contribution under the nursing homes support scheme from 5% to 7% and abolishing the requirement to backdate State support to the date of the commencement of the scheme for those who were in nursing home care prior to that date.

It is quite obvious that the Minister is continuing to take more and more money out of the pockets of older people. We already saw major changes in the budget this year where the respite care grant, the home care package and home help hours were reduced. In some cases, as in my county of Wexford, the home help service is in abeyance because the HSE is not providing the monies for an increase in home help services. It is very difficult to get approval for new home help applications.

It is quite obvious that if we charge the full cost of private beds in public hospitals, we will further drive up the cost of health insurance. There is already a crisis in the private health insurance market with 1,100 policyholders exiting the market per week although the Minister does not seem to accept that or want to take this situation on board. He continues to drive on with further measures that will ensure that more and more people will leave the private health insurance market. A total of 2,078,000 people were insured with inpatient health service plans at the end of March 2013. This represents a reduction in the number of insured people of 21,000 in the first quarter and 61,000 over the year. The market peaked at almost 2.3 million at the end of 2008 but because of job losses, reductions in wages and other issues, people have continued to leave the private health insurance market on a regular basis.

In respect of charging private patients the full cost of beds in public hospitals, most people are entitled to universal health care by virtue of their citizenship and status as taxpayers. If we charge the full cost of private beds in public hospitals, we will further drive up the cost of health insurance and force more and more people out of the market. People are voting with their feet on this issue. All health insurers agree that it is a very serious challenge to the sustainability of the market. As Deputy Finian McGrath outlined earlier, the Insurance Ireland Health Insurance Council, which includes the State's four main insurers, has warned that the Government's proposed new public bed charge will lead to an increase of over 13% in health insurance premiums. In a submission to the Government, it said that a price increase of this magnitude would force over 300,000 members out of the health insurance market, leaving just over one third of the population insured by 2015. A significant further exit of people from the private health insurance industry would have a dramatic and appreciable impact on the public hospital system as the cost burden of these individuals is shifted from private insurance to the Exchequer. There are already huge waiting lists in our hospitals. People are waiting months and sometimes years to see consultants. The delays, which are continuously highlighted by the general public, are nothing short of a disgrace. Some people are waiting for over a year or 18 months, many of them with serious illness, are finding it very difficult to see a consultant to diagnose them and are finding it nearly impossible to get into hospital because of the lack of speed of consultants when dealing with people who are seriously ill.

The hospital system in Wexford has been redesignated by the Minister and we now find ourselves in no man's land. At the moment, we are tied to Waterford and Cork.

It is the Minister's intention that Wexford patients will go to Dublin eventually and he should explain when will this happen. Many people are concerned they may have to go to Waterford, Cork or Dublin. Last week people from Wexford who were patients in Waterford found it impossible to get into the Mater Hospital, St. James's Hospital or St. Vincent's Hospital.

Private hospitals have warned they are in danger of closing if the Government presses ahead with plans to charge private patients the full cost of using public hospitals. The Minister must listen to private health insurers and private hospitals, because they are expressing concern about what will happen. They are not making it up and it is not out of a comic show. It is the reality but the Minister does not seem to want to listen. He seems to have no interest in what the providers of the services state. I call on the Minister to explain why he continuously ignores the views of private health insurers and private hospitals and the warnings they send out.

The nursing homes support scheme, which was known as the fair deal scheme, has been running for a number of years. More than 20,000 people avail of the service in long-term residential care. The scheme pays towards the cost of care for those participating, with individuals contributing 80% of their income and 5% of their assets per year fixed at a maximum of three years or 15%. In the Bill the Minister wants to increase the maximum proportion of a person's assets payable from 5% to 7.5% with a cap at three years or 22.5% in the case of principal private residences. In 2013 the budget for the scheme was €974 million. I do not know whether it was the Minister or the HSE who made a particular decision with regard to the nursing homes support scheme in rural Ireland. People applying for the nursing homes support scheme receive letters stating they are on the national waiting list for funding but the Minister tells us there is adequate funding. I am led to believe there was a huge build-up of applicants in Dublin and Cork and that the Minister instructed the HSE to put on hold applications from rural Ireland until Cork and Dublin applicants were approved.

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