Peadar Tóibín (Meath West, Sinn Fein) | Oireachtas source

The health system is in crisis without a shadow of a doubt. In recent years, approximately €3 billion has been taken out of the health system. The system has lost thousands of staff and thousands of beds have been closed. This year, we are set to see between €666 million and €1 billion being taken out of the hospital system. This means hospital services are being closed. For example, we have seen eight of the nine HIQA watch-list hospitals lose their emergency departments. Our Lady's Hospital in Navan is now the last hospital on the watchlist but there is a threat to close its department by December 2014, despite the fact that there is insufficient capacity elsewhere in the system. These decisions are not being based on patient safety but on the fact that costs have to be cut due to budgets. The health chiefs of the major Dublin hospitals said as much in their letters. When the Minister was involved in the budgetary process, he said as much also.

The health care system needs root-and-branch reform. We need a system that allows access at all levels for all people on the basis of medical need alone. The two-tier system is grossly inequitable and immensely inefficient. It must come to an end. We need a new universal public health system that provides health care free at the point of access on the basis of need and funded through the general taxation system. We need a new system based on public service and social solidarity. We need a system in which the State does not heavily subsidise the private sector while at the same time expecting public patients to languish on public waiting lists. We need a system whereby a baby in my constituency does not have to die from meningitis three minutes from hospital, having waited for an extended period for an ambulance to arrive. We need a system in which a rugby player does not have to wait 45 minutes for an ambulance on his having received an injury and in which a man does not have to die of a heart attack in the Newgrange Hotel having waited 40 minutes for an ambulance. We need a system in which a man in Canistown does not have to die after waiting 40 minutes for an ambulance, in which a road traffic accident victim does not have to die after waiting 25 minutes, in which a child stuck under a 1-tonne industrial gate for 50 minutes does not have to suffer internal injuries while awaiting an ambulance, and in which a victim of serve stroke does not have to wait 40 minutes for an ambulance before being brought to hospital. There was a case recently in Rathoat in which a person had a panic attack and became unresponsive and unconscious and stopped breathing. That person had to wait 35 minutes for an ambulance to arrive. The day of the health service we desire is not here yet. The figures I have outlined are admitted by the HSE in its press statements. The problems of the two-tier health service continue unabated.

Significantly, costs continue to rise, for both the end user purchasing private health insurance and the State. The cost structures are not being properly tackled. A large number of people are caught in the austerity trap. In the past year, some 60,000 people have been forced to forgo private health insurance. Most of them, many with young families, are struggling to make ends meet and pay for health insurance. I fear the steps being taken may lead to further increases in the costs associated with the private health care system. Therefore, we will see many more tens of thousands of families shedding their health insurance over the next while.

We will not change the Government's ideological bent on this issue any time soon. It is necessary to ensure that some social solidarity and intergenerational solidarity exist within the system. It is, therefore, positive that risk is equalised within the health system and that customers are not discriminated against on the basis of age, gender or health status. This element of the Bill is a step forward and I welcome the Minister's input into it.

It is very important that the cost issues within the private health system be focused upon. There is a major imbalance with regard to the age spread of those with private health insurance, and there is also a major imbalance with regard to pay rates in the private health insurance sector and the health service itself. We have seen that come to light this week. Until these imbalances are actually dealt with, it will not be possible to lower the cost of health insurance for the end user.

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