John Halligan (Waterford, Independent) | Oireachtas source

If the public needed evidence that we are further than ever away from the universal single-tiered health service promised by the Government parties ahead of the last election, which guaranteed "access based on need not income", it need only read this Bill. The Bill promotes what the Government sees as a cost-effective private health insurance market without moving to a clear timetable for the introduction of universal health insurance. It makes clear in one sense that mandatory private health insurance is still the Government's goal. The taxpayers who are being incentivised to purchase private cover already fund the health system. The one third of their salaries taken in tax pays for the provision of hospitals, doctors and nurses. The Government is attempting in this Bill to dupe them into not realising that private health cover is effectively double taxation. That approximately 300,000 people have left the private health insurance market since 2008 speaks volumes. Many who managed to hold on to it are struggling to do so. They are terrified by the prospect of ridiculously long waiting lists, particularly for non-life threatening illnesses. None the less that has the potential to make their lives miserable. Almost 1,000 people have been waiting for over two years for outpatient appointments at the University Hospital Waterford, despite numerous promises from the Minister for Health and his predecessor that these waiting lists would be tackled. I and many others believe that people are not signing up for the privilege of a private room in a hospital as private cover guarantees the insured in many hospitals in Europe. For most procedures, regardless of the level of cover, the patient will be put in a ward in a public hospital, like it or not. I have spoken to many in the past few months who had the top level of health insurance but that did not matter.

Many of the 100,000 who bought private cover over the past 12 months to beat the new deadline that would have made it more expensive as they got older did so as their confidence declined and they had a sense of panic about what was happening in the public system. They did not sign up because they thought they were getting a bargain, as many Ministers and Government public relations attempted to portray it to the media. Many have no choice but to have private health insurance because they know the consequences of going through the public system, with waiting lists for elective surgery or to see a specialist or consultant.

Some of the previous speakers said that consultants are not getting the money they should get. This is probably one of the few countries in the world where consultants do not work weekends or do shift work. It is outrageous. If a person has a heart attack at the weekend in Waterford, he or she is sent to Cork or Dublin because at 5 p.m. or 6 p.m., there is nobody there, apart from a consultant on call and a patient is lucky to get him or her. I do not know what the opinion polls show but when people analyse what is happening in the health system after this length of time and all the money supposedly spent, they will realise that they are afraid to turn up in a hospital because they may have to wait to be looked after. I have brought two or three examples to the Minister’s attention of the dire consequences of not having a specialist on duty. In one case, a man who had four stents complained of chest pains but as there was no consultant, he was seen by a doctor in the accident and emergency department who took approximately 30 minutes to get there, through no fault of his own. The coronary ward was full and he could not get into it. The man died. While I am not saying he would have survived had there been a consultant in the hospital, he did not have the chance he deserved. There are people waiting in the long grass on this issue. That man's family, who have appeared on "Prime Time", were not necessarily supporters of mine or anti-Government. I do not know what their politics were but it is a big family and they are aggrieved and in a state of shock and turmoil because of what happened to their father. This is serious in many hospitals. I can only speak for what is happening in the hospital in Waterford. Nothing is being done despite all the promises made about regeneration of the hospital services with 24-hour coronary care. That has not happened and will not happen this weekend when somebody might have a heart attack.

There is a generation of people with private health insurance who are already financially crippled by the universal social charge, colossal mortgages, property tax, and the list goes on. As far as I can gather from this Bill, and the Minister can correct me, it will not guarantee that the cost of insurance will go down at all. It will go up and insurers can put it up if they wish but there is no guarantee it will go down. Insurers will be allowed to retain discretion on whether to introduce higher rates. The health insurance levy went up 149% in the past five years. The Minister says he hopes to create a culture of competition between private providers. That is not good enough because he and I know that will not happen. It will go up and it is unlikely that it will go down. If it goes down momentarily, it will go back up.

Another disappointing aspect of the Bill is that it does not address pre-existing conditions. These will not be covered for up to five years by a private health insurer. If a person wishes to upgrade, and no doubt many will because the entry level provides very basic cover, insurers will be allowed to restrict cover for any medical condition that existed prior to the previous level of cover for at least two years. That should be reconsidered. I do not know what it means but it is terrible. Bringing forward the Bill is the Government’s attempt to create a sense of urgency and panic, coupled with the problem of waiting lists and the overall decline in the public system. It is scaremongering many young people into purchasing health insurance that they cannot afford.

It is all very well for those of us in opposition to be critical, and the Minister is right to say that at times we can be critical and do not offer alternatives. Some of us do but some of us just posture. I do not make derogatory remarks against any Minister or member of the Government but on the issue of health, we are nearing the end of 2015 and the start of 2016 and while there is no question that the previous Government bears much of the responsibility for what happened in the health service, the Minister is completely wide off the mark in that he has not listened to people who work in the health service or to people like myself and other Deputies who are inundated every week with calls to our constituency offices and who meet people in our constituency offices who are strapped for cash and cannot get even the basic care they need. The quality of life in any society is based to a large degree on the standard of education and health and while I am not speaking about the issue of education, we cannot but say that the health service is in meltdown. If one speaks to any people who have been in hospitals around the country, they will say that the health service is in a critical state, with waiting lists to try to get access to the service. In a western country if we cannot depend on a consultant to help save someone who has a heart attack on a Friday, Saturday or Sunday, that says it all.

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