James Reilly (Dublin North, Fine Gael) | Oireachtas source

I do not think any specific reason has been identified to date but the matter continues to be examined. I am concerned that in the past there has been a history of passing on increases to the customer. There was an acceptance, or even a resignation, that medical inflation runs at 9% yet in some years we have seen health insurance costs for consumers increase by up to 25%. That is not acceptable to me and it is why I am asking for much more robust auditing, particularly from the semi-State insurer, the VHI. On behalf of the people, I am the sole shareholder in the VHI, so I want to see a clinical audit introduced there in a far more aggressive and robust manner than has been the case to date. Anecdotally, we hear about many tests being done, the value of which could easily be questioned by a competent fellow professional.

Why are we still paying the same rate for procedures that used to take two hours but which now take 20 minutes using modern technology? A whole range of services are currently being provided in this way whose prices should be reduced dramatically.

We must also examine the appropriate skill-mix in the private health sector. Procedures are being carried out by specialists in hospitals, which attract a specialist's fee and the side-room fee, which could be carried out in primary care. Some of these procedures could be carried out by advanced nurse practitioners. All these areas need to be addressed and will be as a consequence of Mr. McLoughlin's report.

See this speech in context