Clare Daly (Dublin North, United Left) | Oireachtas source

I listened before lunch to Deputy Buttimer berate the Opposition for the fact that there were no Opposition Members present when he was giving us his deliberations and it is somewhat striking that there are no Government representatives here now either. It is a ridiculous point to make, given that what is happening in the health service and the future of that service is being dictated outside, rather than inside, of here. I refer to the fact that today there is the first ever GP protest outside the doors of this House because ordinary doctors feel they have not got the wherewithal to continue and many new entrants to the profession are being forced to leave these shores because they simply cannot make ends meet. We listened to them on the radio this morning talk about the significant reduction in income to their practices.

We must see this Bill, yet another on the health service, in the context of the overall situation with the health service, which is not unfair to characterise as a bit of a shambles. There was the recent appointment of the Minister, Deputy Varadkar, who verified what we all knew anyway about the ridiculous universal health insurance proposal that the Government had put forward lying in tatters. As nearly once a week there is some sort of health service amendment Bill in the House, we must start by asking whether the best way forward is this patchwork quilt of changes onto a dysfunctional health service and whether we would be better off stepping back and looking at the whole proposition.

Sadly, in terms of context, the Irish people have never had access to a universal health care system. We rely on a procedure whereby there is a means-tested medical card giving access to State-funded care or, if one does not meet that means test, one can opt to apply for private health insurance, or else one can take one's chances and not do anything. The VHI was set up as a semi-State body with the Minister for Health as the sole shareholder. In the absence of proper State-funded health care, it was supposed to provide affordable health insurance subsidised through income tax relief for those who would not qualify for a medical card. Instead, there is this hybrid system which is in tatters. In terms of private health insurance, while it may mean faster access to care facilities, in fact, waiting lists are still a problem. The reason for such waiting lists is that the number of inpatient beds has been cut by over 5,000 since 1981, and this has not been compensated for by the increase in day places. Cuts in public beds have led to growing inequalities of access, waiting lists and all of the other problems that were highlighted earlier in the debate. There is an Irish apartheid in the health system. The idea of universal health care and all of the other grandiose proposals that were flown like kites reflect an influence from the private health market and the globalised private health insurance allegedly promoting competition but, in effect, introducing an American health model into Europe which the public does not want. We must look at any changes we make in the context that in basic health care we are in Ireland way behind the European average. Ireland has lower mortality ages, a higher burden of chronic long-term illnesses, poorer outcomes and survival rates etc. We must look at this legislation in the context of that background.

I do not agree with the piecemeal approach. In an overall sense, it is good to raise the standards of health and care professionals. The idea, for example, of including opticians, is a laudable objective, but we would be one-sided if we looked at the addition of that profession being covered by CORU and did not look at the experience of how CORU has been working already. If the body that is supposed to regulate is not working all that well, there is no point in adding a new profession. I would like to look at that because the addition of opticians per sein some ways is neither here nor there. The opticians made the point articulated already that it is a little excessive that the new registration would require all staff, including non-clinical staff, to be registered with CORU. That seems excessive. Such non-clinical staff are not involved in medical procedures and in giving medical advice and in that sense, they should not be included.

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