Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance) | Oireachtas source

The Taoiseach has fundamentally betrayed his promises to the electorate in the area of health insurance. One of the central planks of his party's pre-election manifesto was the great promise of universal health insurance. He says he is still committed to that, but it is absolutely clear that it has been put so far back as to be a really meaningless objective now.

Is it not the case that in recent weeks the Minister for Health, Deputy Varadkar, has essentially been acting as an advertising agent for private health insurance? He has been scaring people over 35 into taking out private health insurance before a deadline, or to endure penal premiums that will increase over the years. That indicated a fundamental abandonment of the idea of a single-tier system, with the Minister actively championing the two-tier system.

Why would anybody take out private health insurance? The only reason people would do so is because they believe they will get premium care over and above what people get in the public system. People are being encouraged to do that due to fear of the situation in the public health system. They look at the public health system with its longer waiting lists, trolley crisis and massive cutbacks, and say: "Oh my God, maybe I need to take out private health insurance in order that I will not have to suffer that."

The Minister is reinforcing the notion of a two-tier system by saying: "Get your private health insurance now or we'll penalise you." Is it not the case that the Taoiseach has fundamentally backtracked on the principle of universality? The Minister, Deputy Varadkar's, deadline essentially means that this Government is reverting to championing actively a two-tier health system.

My second point, which is connected, concerns the mess in the public health system. Whatever the Taoiseach may say, evidence is piling up that the situation in the public health system is getting worse. Last week, statistics revealed that 71,000 people have been waiting longer than a year for an out-patient referral. That is a huge figure. The Minister admitted that in the case of St. Vincent's Hospital and Loughlinstown Hospital, the reconfiguration process had actually worsened the situation. Last week, the Minister said it cannot be dealt with without extra resources going in. Are those resources going to go in or will the crisis continue to get worse?

Last week, doctors in Beaumont Hospital described the situation for those waiting in the accident and emergency unit as "institutional abuse". It is a pretty serious allegation for doctors to write to Tony O'Brien in the HSE and say that the hospital was guilty of institutional abuse against patients. Patients were afraid to leave the plastic chairs they were sitting on in case somebody would take them when they were awaiting admission to a bed. That is an outrageous situation.

There were record numbers on trolleys in February. Meanwhile today, psychiatric nurses in Galway are taking industrial action again after they were forced to walk out a couple of weeks ago due to assaults on staff. They believe that is the result of a lack of resources, including inadequate staffing.

Notwithstanding promises made by the Minister when the walk-out occurred, that negotiations would take place and the issue would be addressed, it has clearly not been addressed. Otherwise they would not be taking industrial action again today.

While it is implicit in the Galway case, in Cork a psychiatric nurse was suspended for blowing the whistle on patient safety issues. In the Portlaoise case we know that frontline staff were making reports to senior management about a lack of resources and dangers to patient safety, yet they were ignored. From how many other places are we getting reports of this kind by frontline staff that are either being ignored or silenced by senior management? Is there a policy to hush up the dangers to patient health and safety issues, instead of addressing them through the necessary resources and staffing?

All these issues point to a serious and worsening situation across our public health service.

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