Donnchadh Ó Laoghaire (Cork South Central, Sinn Fein) | Oireachtas source

There is an old cliché about asking for directions only to be told that one should not start from one's particular location. The Irish healthcare system is the classic example of that in policy terms. I speak to constituents who have arrived here from other countries in recent years and cannot fathom the system we have, including the mixture of public and private provision, the cost of visiting the GP - which some people have to do frequently - and the cost of prescriptions. Somewhere in there is an ostensibly public system. It is a crazy mishmash and it is extremely ineffective and wasteful.

The provisions in this Bill relating to risk equalisation make sense only in the context of our crazy system. It is necessary to equalise risk. However, as every speaker has said, we need to alter the system fundamentally. We need a healthcare system where people can rely on public provision. Healthcare provision is a public good and everyone should be able to expect a decent quality of care through the public system. That is where we need to get to. We have all made that point but the past few Governments have not done very much about it.

I want to raise a specific issue in regard to health insurance. It is one that has been raised with me by constituents on a few occasions. People who are going into hospital for a procedure may be told by the doctor that they should be admitted the night before. They go in the night before, they have the procedure the following day and they might stay that night as well. However, their health insurance company will only cover the second night. That is not something patients expect because they went in through private health insurance. They could be left footing bills of €800, €900 or €1,000 for that bed night.

It is crazy. Constituents do not expect it. The health insurance companies should be picking that up. There is evidence from doctors that consultants are writing to the hospital claiming the stay was necessary for the person's care. It might be a relatively small issue in terms of the numbers of people affected. It is a serious issue, however, if people get a bill for €1,000 which they are expecting their insurance company to fork out for. It really is not good enough.

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