Maureen O'Sullivan (Dublin Central, Independent) | Oireachtas source

It is almost beyond belief we do not have a state-of-the-art health system when we consider the budget is €13.626 billion with a further €397 million in capital funding. I wish to make a general point about what is good and excellent in our health service. Excellent medical care and quality of services is provided in the areas of caring for people with cancer and advances for people with heart ailments, transplants, by-pass operations and stent procedures.

A friend of mine has had motor neuron disease for six years and with regard to long-term illnesses there is a great need for co-ordination of services. Her main carer spends much time making calls to a variety of services, whether for occupational therapy, palliative care, physiotherapy, home care, medical care or with regard to incontinence issues, instead of being able to make one call to a central person who could look after all of this.

We know we have a two tier system and most people would like to have a system which is fair and which treats people equally and in accordance with their needs and not their ability to pay. In the 1970s I bought into private health insurance and I am not too sure why. I have paid into it for more than 40 years and thankfully I have been very healthy and have only had to avail of it on three occasions for very minor procedures. The private health sector has received quite a lot of money from me and this is fine. In this system when one goes for an appointment it is speedy and prompt and when one arrives in the hospital one is dealt with efficiently and speedily. The procedure takes place and after care is provided. I do not understand why this cannot happen in the public health service also. Why can we not have prompt appointments and speedy delivery of services?

We know we have waiting lists and that we also have waiting lists in accident and emergency departments. I acknowledge the improvement in the new accident and emergency system in the Mater Hospital. In 2008, 2.3 million people had private health insurance. We have been told about the percentage decrease from 50.9% to 45.8%. One would need a degree to work one's way through all of the various private health plans and programmes available to establish what is cost-effective.

Regardless of the pros and cons of the proposed charges, or the philosophy behind private health insurance, I find the reaction of the private insurers predictable but not very helpful. They state this will lead to an increase of more than 30% in health insurance premiums and that the number of people taking out health insurance will decline. Aviva has stated the insurers simply cannot bear the cost and remain in business. VHI states it is the single biggest challenge facing the market. Laya Healthcare speaks of it as a significant threat to affordability and sustainability of private medical insurance. At least GloHealth asked for initiatives which would not drive up premium costs and which would entice young people to be explored. I call on the industry to examine wastage in private health care and for more efficient use of their resources. In 2012 the providers took in €2.3 billion but their only answer to this is to increase premiums.

Will outsourcing the operation and administration of the scheme by the HSE to another party mean it will be profit-driven rather than person-driven?

Primary care centres have been a major issue. I am still waiting for an update on the proposed primary care centre in the Summerhill area of Dublin 1.

The Library and Research Service included a section from Maev-Ann Wren from Trinity College's centre for health policy and management. She looked at the impact of demographic change. The number of people aged over 85 will more than double by 2021. The number of people aged between 74 and 84 years will increase by more than a half. It is vital that we get preventative measures right. There is much more that we could do on prevention. Illnesses that can be prevented include heart disease, diabetes and certain cancers. We are aware of the massive cost from alcohol abuse and alcohol misuse, yet the various recommendations and suggestions are not being taken up by the Government. I, like other Members, attended a presentation by the Alzheimer Society of Ireland. We are aware of the small amounts of funding that can improve people’s chances and keep them out of the system for as long as possible.

Investing in carers is an investment in community care and it helps families and communities and those people who want to stay at home for dignified living.

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