Joan Collins (Dublin South Central, People Before Profit Alliance) | Oireachtas source

The Bill is part of the plan of the Minister for Health, Deputy Reilly, to introduce universal health insurance. This is based on a Dutch model, which from my reading is not one I would examine. I would have thought that a Government with a significant number of Labour members should be looking for a service based on the national health service in Britain. This initially came from the needs of people in the communities and their need for proper maternity hospitals and hospitals for sick people. To provide those services, society can then decide that if it wants to provide these services for the elderly, the young and the general population, it must find the money. That comes down to taxing people who can well afford to pay more or setting aside some part of tax, as PRSI was supposed to be, to provide health services. That is the progressive way to provide services under a progressive taxation model. This must include people who work on the front line, Ministers, the people who use the service and the needs of the community.

I am sure all Members receive a report by the private nursing home sector, which is not an area I support. It gives figures and facts to the effect that, by 2021, the needs of the elderly, those over 65, will not be met on the basis of what we have and the amount of money the public service will put into providing long-term nursing home beds. Between 2009 and 2012, approximately 339 new nursing home beds were introduced, compared to an annual increase of 1,000 beds in the years prior to that. By 2021, we will need 221 nursing homes built to provide for our elderly, particularly those over 85 years.

This must be planned for. If society says we must look after the elderly in this fashion, we must see how we can fund it and we must have the debate. That is what politics is about. As a group of people or a party, we can set out that we will tax here or there to provide the service, increase tax or box off a certain amount of tax to provide it. The universal health insurance model will not work. As the previous Deputy said, it will service private companies.

The HSE has fallen apart. It is one of the worst models ever set up to service people's health needs. We hear horrific stories of people trying to get into the system. Once people are in the system, they feel they are getting a good service and that they are being looked after. This only occurs because of the will and the fact that we have well-trained nurses who give far beyond their time and energy in respect of what they get paid for. People in my family work in Wexford General Hospital and stay after they have finished their hours to assist people who are ill. They are under ferocious pressure. A member of my family in her early 60s feels she must leave because she does not have the will or the energy to face going into hospital every day and the pressure on her. She is an excellent nurse, one of the best one could ever meet. We are losing good people because they cannot take the daily pressure in hospitals and the extra work they must do. Work is falling on fewer shoulders every month and new people are not coming in because of the moratorium.

I do not support the context of the Bill because it is part and parcel of the universal health insurance model, which I do not support.

The chief executives at Tallaght and other hospitals have stated that any more cuts will bring us to a point at which hospitals cannot deliver the necessary care, as they have been cut to the bone. We have seen this first-hand at Tallaght, as there have been no spinal surgeons at the hospital for the past eight months. It has cost the HSE €350,000 to provide the required care at the Mater Private Hospital. I would be the first to argue that these patients should be seen in a timely manner but the HSE model should have provided the necessary surgeons in the first place. The information I have - it is not a definite fact - is that the surgeons left their posts because of the pressure in the hospital. The hospital engaged another surgeon, who also left quite quickly because of the pressure. If that is what happens in hospitals in one area, it is happening elsewhere in the health service.

This does not take into account the issues of maternity hospitals, the mental health needs of the population or other issues. We need to get a breakdown of the needs of our population into the future, matching that with funds and having a debate with people. We must have a discussion of what the cost will be and how to cut the fat so we can put more money into front-line services. That would procure the goodwill of the people, as they know that if that is what is required, it should come about. That would lead us to a good health service with a standard that our families need. There must be 221 nursing homes built over the next six or seven years to provide a service for people over 85, based on the figures that have been coming through.

Pharmacies do not seem to have passed on the reductions for generic pricing of pharmaceuticals. I do not know if the Minister of State knows that a report was published the other day detailing the costs of pharmacies throughout the country, and people are not seeing the effects of cuts.

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