Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

We had detailed discussions about this on Committee Stage. The Minister referred to the fact that this is about making sure risk equalisation is maintained along with the concept of community rating and intergenerational solidarity to ensure affordable health insurance. However, the biggest recruiter for private health insurance companies is the fact that our public health system is in chaos. Week in, week out people consistently experience delays accessing diagnostics and treatments and that is why people who are anxious, concerned and fearful are forced to take out insurance because if anything happens to them or their families, they simply could not access the public health system.

I have never said there is a quick fix solution to the broader difficulties facing the health services but the notion that an 18 month waiting period is deemed acceptable for people to access diagnostics, consultants or treatment is wrong. That is why there is a change in the perspective of people taking out private health insurance. While the improving economy is a factor, the key factor driving people into taking out insurance is that companies are offering coverage for the basics, which they should be able to access in the public health system but cannot. Companies are not offering anything above and beyond basic coverage.

Until such time as there is a level playing pitch in terms of access based on clinical need, there will be a continual move of people into the private health insurance market, not because of what is being offered but because of what is not being offered in the public health system. What is not being offered in the public health system is basic access to basic healthcare. The Minister talks about the roll-out of universal health care, but in the meantime, while that grand plan is being announced and universal health insurance is being shelved, there are 400,000 people waiting for an outpatient appointment. There are tens of thousands of people who have been waiting for over one year for diagnostics and treatments. That is what is happening in the public health system. The Bill is about ensuring risk equalisation is maintained, ensuring the efficiencies of same, maintaining inter-generational solidarity and lifetime community rating and encouraging young people into the system. Private health insurance should offer something over and above what people should expect from the public health system such as private or semi-private rooms or other facilities. That is why people take out private health insurance. We should be conscious, however, that people are now taking out private health insurance not because of wonderful offers but because of the appalling scenario visited on people day in, day out in the public health system in accessing basic healthcare. Reference was made to the matter today during Leaders' Questions when Galway University Hospital and the incident in Cork in which a young child had to wait for an inordinate period on a trolley were mentioned. These are all things that put fear into people.

Until such time as we accept the the roll-out of universal health care is welcome, we have a huge problem that is not being dealt with and we will see this problem escalate over the Christmas period. There will be further cancellations of elective surgeries and a back-up of outpatient waiting lists. That is what will happen again this year and the Minister will applaud himself because of his supplementary budget of €665 million, but the bottom line is that he has simply not got to grips with the overarching problems in the delivery of basic healthcare. When we talk about encouraging people into the health insurance market, it should be about encouraging them to lighten the burden on the public health system and it should not be done by forcing them to take out private health insurance because the public health system simply cannot deliver healthcare. That is the reason there has been an increase in the numbers taking out private health insurance.

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