David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I thank the Minister of State for his contribution to what has become an annual debate on private health insurance. I will support the Bill. Having said that, we should take the opportunity every year when we debate such a Bill to review where we are with Sláintecare and with the commitments that all parties in the House gave to phasing out private health insurance and the private health sector, and to working towards a public, universal healthcare system where people are treated on the basis of need and not of how much money they have in their pocket.

The Minister of State set out what the Bill will do, which we will support, but there is a fundamental question to be asked as to why people take out private health insurance. The vast majority take it out because they feel that they need it, that they cannot depend on our public system and that if they get sick, or if a family member gets sick, the fastest route to help them is through private health insurance to get a scan, a test, an assessment, an appointment or treatment. That is true. The problem is that all those who cannot afford to take out private health insurance are left on public-system waiting lists. According to the most recent figures, 613,000 people in the State are waiting to see a hospital consultant, with 150,000 of them having waited more than 18 months. Where in God's name is the delivery of Sláintecare, which promises that people should not have to wait longer than four months, when 150,000 people in the State have been waiting more than 18 months, some of whom, in areas such as orthopaedics or scoliosis, are children? It is a scandal and it will not happen until we make a commitment to properly resourcing our public hospitals and to recruiting the consultants, the specialists, the nurses and the healthcare assistants we need, and until we put public beds into public hospitals.

There is also an issue with what people get for private health insurance. Most people who take it out pay tax, PRSI and PAYE, and if they get sick and go to a GP, they have to pay for that as well. That is the reality for many people. We are charging, double-charging and treble-charging people for healthcare instead of committing to delivering on the promises we all collectively made in respect of Sláintecare to deliver a better public health system. When the public system does not provide a service, the private, for-profit system will step in to deliver it more quickly if it gets the opportunity to do so.

There was an example in my constituency. Ten years ago, there was a campaign for a second cath lab at University Hospital Waterford. I was a member of Waterford City Council at the time and a delegation from the hospital explained to us that if somebody had a heart attack outside of 9 a.m. to 5 p.m. anywhere in the south east, he or she would have to travel to Dublin or Cork for an emergency cardiac procedure, or what is known as a PPCI. Two years ago, the then Minister for Health signed off on a second cath lab, but to this day, not one brick has been laid in that area because the political will was not there to make it happen because of the way in which capital projects are delivered in the State. The private hospital built a cath lab, which I do not blame it for, and it is providing a very good service. From conception to delivery, it took the hospital six months. Within that time, a private hospital was able to say it would build a second cath lab, open and staff it and provide the service, yet after ten years of campaigning, and two years after it was first supported by the then Minister for Health, still not a single brick has been laid. The same Government - Fianna Fáil, especially - that promised people that it would deliver 24-7 emergency cardiac care in our public hospital still has not done it and is still hiding behind reviews, yet it is now talking about expanded out-of-hours services but not the 24-7 care that was promised. That is what happens and part of me thinks that is what Fine Gael wants, namely, not to deliver for our public health system and to allow the public healthcare system to step in.

I will support the Bill, only because change needs to happen, but an awful lot more needs to be done to advance Sláintecare and to phase out once and for all the private, for-profit healthcare system, which means that some people get treated more quickly depending on how much money they have, as opposed to people being treated fairly depending on their health need.

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