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

The previous speakers have outlined clearly that Sinn Féin supports the legislation, although we will be tabling amendments because we recognise the reality that many families rely on health insurance because they feel they have no choice. That is not a reality that we savour or are heartened by. In truth, we have a very poor model, a model that is expensive and ineffective because of the duplication that exists in the public and private systems. This is the case with several public services, unfortunately. We should have a system in which you pay your taxes based on your income and consequently expect decent public services, but the system we have means you pay your taxes and then, on top of that, pay €60 for the general practitioner, pay an inpatient fee, potentially pay for health insurance, pay a voluntary contribution to the school, pay third level fees and pay any amount of additional charges. My attitude is that people should be entitled to public services on the back of the taxes they pay and should not be asked to pay twice. The latter seems to be the model of the State. Nowhere is it more obvious than with health insurance. I support many of the calls my colleague Deputy Cullinane has made.

It seems the Government is not pursuing the implementation of Sláintecare and its vision of a public healthcare system with anything like the vigour and enthusiasm that are needed. I urge the Government to move forward with the public-only consultant contract. It is a crucial step that must be taken. It will not be cheap by any means but it is an important investment in the future shape of our healthcare sector. It is absurd that having consultants working only in public hospitals with public patients would be a new development, but that is the case. It should not be beyond anyone's expectations for such a system to be in place but, unfortunately, the way our healthcare system has operated means it would be a radical departure. That is where we need to get to.

I raise a specific issue relating to an anomaly that arises out of the Covid period. I will forward the details to the Minister of State. Many health insurance plans cover private procedures in public hospitals. There is good and bad in that system and it is not ideal in many ways. However, those are the policies that exist and are purchased by people. During the course of the Covid crisis, the State, in effect, took over many of the private hospitals. In fact, I would say it was, to a large extent, a formal takeover. Those hospitals performed public procedures. I had an X-ray in one of the private Cork hospitals as a public patient during that time. A person who contacted me had a procedure for glaucoma in a private hospital during the same period. He anticipated, as did his GP, that he would be refunded for it because the hospital to which the GP referred him for the purpose of undergoing the procedure was operating as a public hospital. Unfortunately, his insurer has taken a different view and despite the fact the facility was operating as a public hospital at the time, is not covering the procedure as what it was, namely, a private procedure in a public hospital. This is grossly unfair and I am sure this person is not the only one who has been caught by this. I will forward the details to the Minister of State and I ask that it be addressed.

I have serious concerns about the healthcare system in the coming months. The number of people on waiting lists, at 897,000, is enormous. It is the guts of 1 million people. The number includes 97,000 children waiting for procedures, some of them very serious. A total of 200,000 people are waiting more than a year. I want to bring a particular focus on the 106 people who are on trolleys in Cork. It is important to note that we are far from being into the worst of the bad weather or the worst of the flu season. I have been calling for a number of months for a specific plan for Cork, which seems to be among the worst-affected areas in terms of pressure on beds. Some of that is because of the lack of follow-on facilities. We have fewer step-down beds now than we did before the Covid period, which is a huge problem. We need a tailored response for Mercy University Hospital and Cork University Hospital because the situation seems only to be getting worse. Cork has had some of the highest numbers of patients on trolleys in recent weeks and months. I urge the Minister of State to take that on board and to work with the INMO and the two Cork hospitals to put in place a dedicated plan to ensure we do not have more than 100 people on trolleys every day for the next couple of months. I do not mean to be alarmist but that danger is there and it is very concerning.

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