Richard O'Donoghue (Limerick County, Independent) | Oireachtas source

This health insurance Bill is about looking at the risk equalisation scheme for all health insurance providers. This is one of the many Bills that have been brought forward so the amount of money paid to the health insurance companies by way of credits can be reduced. These risk credits are paid on the basis of age and gender. Risk needs to be spread so newer entrants coming into the market also bear the cost of risk. The money paid into the equalisation fund comes from a stamp duty paid from every policy sold. There are two distinct pay-outs, namely, risk equalisation credits and hospital utilisation credits. Risk equalisation makes it easier for insurers to carry higher risk profiles, for example, those with higher medical costs because of age, medical history etc. so they can compete in the market with other providers. As happens with all insurance claims, there must be an incentive for the insurance companies to fight a claim. On this, instead of paying out excess amounts, the Government is now proposing to pay a portion of the claim. This should also help reduce the stamp duty paid on all policies. Sections 5 to 7, inclusive, will revise the section relating to equalisation credits, health credits and the high-cost claims. I understand this will be enacted in January 2022.

The National Treatment Purchase Fund, NTPF, indicates 644,458 people are now waiting for their first appointment. The number of people waiting on a day care procedure is 74,662. This is harrowing and very upsetting. The NTPF also pointed out 217 people have been added to the public hospital waiting list every day since the start of the year.

Some nine people every hour are added to our waiting lists. The Minister of State said earlier that costs are escalating in hospitals. Where is the money going? People are paying insurance to sit on a chair for a day or two or to sit on a trolley for a day or a week. Where is the money going, if it is not going into front-line services? It is not going towards paying our nurses. Most of the positions that have been advertised are managerial or administrative. Why are so many of our Irish nurses leaving the public hospital system? Some of them are going to private hospitals and some are leaving altogether because of the way some of the hospitals are being run.

When will we audit the CEOs of all the public hospitals and the management system? I will make it very clear that a public hospital should be run the same as a private one when it comes to its management system. I see that private hospitals, if they are not run properly, will not stay in business. I am the person who said in this Chamber that some public hospitals have shorter waiting times, shorter waiting lists and their patients spend less time waiting on trolleys and chairs to be seen. One or two of the public hospitals have an ongoing record, since the CEOs were appointed to them, of a situation that is spiralling out of control. I am disappointed to say that one of the hospitals with the highest numbers is always University Hospital Limerick. I want the management and CEO structure in that hospital to be audited and checked to find out why it has the largest number of people waiting on beds. Why does it have the largest number of people waiting on trolleys for hours and hours, and even days, to be seen?

The front-line staff are not the problem; it is the management system. We cannot, at any stage, blame our front-line staff, especially when other hospitals do not have the same issue. Public hospitals do not have the same issue. I did not realise I could speak on my first day in the Dáil. All I had was a small piece of paper on which I wrote one or two notes to give me something in case I got airlocked.

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