Martin Browne (Tipperary, Sinn Fein) | Oireachtas source

This Bill primarily deals with risk equalisation, which seeks to ensure that costs are constant across the lifespan of the individual and are not influenced by factors such as age, gender and health status. It is the only element of equality that is brought to the private health insurance market. The fact that this must be done shows how it divides ready access to healthcare in favour of those who can afford to pay the costs associated with private health insurance.

According to the Health Insurance Authority, the average price being paid by policyholders on 1 January 2021 across all levels of products was €1,440. It is a massive amount of money that many people simply do not have to spare, especially when the cost of living is rising at such a rate. It is indicative of the inequality within the system that ability to pay for private healthcare determines how quickly you get seen. It is not just me or Sinn Féin saying this. Recent research by the Economic and Social Research Institute found that patients with private health insurance receive both outpatient and inpatient care more quickly than those without insurance. This is the two-tier health system that has long been promoted by Fianna Fáil and Fine Gael in order to make up for the shambles they have presided over when it comes to resourcing our health service. This is evident in the fact that under the Governments of the same two parties, Sláintecare has been ignored to such an extent that only recently, two top board members stepped down from the programme because of the lack of urgency in its implementation.

The Minister of State should ask any of the over 900,000 constituents who are on the waiting lists. Sláintecare called for a maximum wait time of ten weeks for an outpatient appointment and ten days for a diagnostic test. Let us take Tipperary University Hospital as an example. Of the 3,979 people on the outpatient list, 1,799 or just under half have been waiting over six months or 24 weeks. This is why we should be discussing universal healthcare where timely access is not dependent on how much you can afford, or on how much you are prepared to scrape together in order to avoid the lengthy lists. Privatisation seems to be the buzzword of this Government. The Minister of State will be aware of St. Brigid’s Hospital in Carrick-on-Suir. It has been closed by this Government and the public was told that private nursing homes would be relied upon instead.

Public community care is on the way out and community inpatient care will be on the chopping block if this Government has anything to do with it. In talking about beds in the community, will the Minister of State tell me if funding is being allocated in the national development plan for refurbishment of the wonderful Dean Maxwell Community Nursing Unit in Roscrea, and if the deadline of 1 January after which long-term stay residents will not be accepted will be extended? While we are talking about private healthcare, why is the Government not talking about providing proper funding to voluntary mental health organisations like CARMHA in Nenagh? It is doing tremendous work for people with addiction and mental health issues but it is facing the prospect of possibly having to close its doors in the new year if it cannot secure funding in the near future. CARMHA is operating on local donations alone, since the funding it received under the Rethink Ireland initiative has run out. It makes a huge contribution to our health system by providing services that are in short supply overall. I have written to the Minister of State asking her to meet CARMHA to discuss the issue and I hope that she will do so.

The Joint Oireachtas Committee on the Future of Healthcare of the Thirty-second Dáil recommended ceasing all private care in public hospitals and achieving a model where private insurance would no longer confer faster access to healthcare in the public sector, but would be limited to covering private care in private hospitals. We cannot delay on that any longer.

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