John Paul Phelan (Carlow-Kilkenny, Fine Gael) | Oireachtas source

Rather shockingly, I must admit to being the third of the past five speakers to have visited Cuba. I did so a number of years ago on the expectation that President Castro would not be around for much longer and the country would greatly change in the coming years. While certain aspects of the health service might work pretty well, the Minister referred to cancer survival rates not being very hectic. What really struck me is that one is advised as a tourist to bring certain items which children in school often do not have, such as pens and pencils. I remember being part of a group that met two young lads. When we handed over pens and pencils to them, they smiled back most graciously. I was struck by the fact they both had immaculate sets of braces on their teeth, despite the fact they were barefoot and had virtually no clothes. Certain aspects of the health service in Cuba might be admirable, but the dire poverty in which most of the population lives, not to mention the political circumstances in the country, are hardly something which are desirable for Ireland.

I welcome some of the announcements made this week, particularly with regard to medical cards. Much pain, upset and angst were caused to people, particularly in the earlier part of 2014 with reviews and the loss of medical cards. The system announced and proposed by the Minister at the start of the week is a welcome development, and will ensure those who have terminal illnesses will not have their cards reviewed, and those subject to review heretofore will not be reviewed again. I welcome the Minister's actions in this area.

I also welcome some of the announcements made today on the HSE's service plan and the provision of approximately €10 million extra for the fair deal scheme. The waiting times at present are certainly too long and I hope the €10 million will go some way to significantly reducing the waiting periods. I welcome the inclusion of capital funding for the new emergency department medical assessment unit and endoscopy unit in St. Luke's General Hospital in Kilkenny, the building of which is under way at present. I hope it will be completed soon.

Some of our hospitals have difficulties recruiting for consultant positions. I specifically refer to University Hospital Waterford which, as I understand it, has 20 vacant consultant positions at present. I am not sure exactly what the cause is because I know many of these positions have been advertised. Sometimes applications are not received, or those who accepted have subsequently not taken up the positions. This leads to a great deal of hardship for a number of families and individuals in the south-east region.

There is not a great deal of disagreement among speakers on all sides of the House on the provisions of the Bill. There is no doubt the past seven or eight years have seen a significant reduction in the number of people who have private health insurance. This has coincided, not coincidentally, with the economic downturn. I hope that as the economy continues to recover and more people are back in work more people will be in a position to take up health insurance.

I certainly welcome the major provision in the legislation on the sliding scale for premiums for those under the age of 25. A great many of us did not have private health insurance when we were under the age of 25. I certainly did not until I was somewhere in or around my mid-20s. As Deputy Farrell pointed out, by their very nature people of that age tend to be more healthy and do not tend to put as much strain on the health insurance market by availing of insurance. However, they are an essential part of ensuring the health insurance market functions properly. The sliding scale proposed in section 7 of the Bill, which aims to reduce premiums to this category of people, is to be greatly welcomed.

While it is unfortunate there will be loaded premiums for those aged over 35 it is perhaps inevitable. In particular it is inevitable that there would be late entry loading for older people in their 60s who take up health insurance for the first time. I fully endorse and welcome the provision in the legislation which provides and allows for the transfer of insured persons from restricted membership categories to other restricted membership categories. Recently one of my constituents was at the wrong end of the existing legislation in this regard and the provision in the Bill is to be greatly welcomed.

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