Dáil debates

Thursday, 1 December 2022

Health Insurance (Amendment) Bill 2022: Second Stage (Resumed)

 

3:44 pm

Photo of Malcolm NoonanMalcolm Noonan (Carlow-Kilkenny, Green Party) | Oireachtas source

Before I reflect on the contributions of Deputies, I give my commitment to Deputy Lowry that if he passes on the details, I will do all I can. It is a heartbreaking story and my thoughts are with that young boy's family and with him. It is a traumatic time. For end-of-life care, it is critical there is coverage throughout the country. The manner in which the family’s wishes are respected is very important, whether it be in hospital, in palliative care or at home. The wishes of that family in that young boy’s end-of-life care are very important and it will be comforting to them in the future that they have had that care. I ask the Deputy to please pass on those details to me and I will relay them back to the Minister on his behalf. I thank him for that.

I want to reflect on some of the contributions of Deputies so far. At the outset, I note a number of Deputies have been critical of the fact there are no Ministers from the Department of Health here. I am a Minister of Government and our officials are here, and we are taking note of all of the comments and contributions of Members. It is a busy time towards the end of the year. I acknowledge that Ministers are incredibly busy but I am doing my duty in being here to represent the Department and the Minister.

I will start with a general comment in regard to Deputy Shortall. It is disappointing to see language that is talking down our public system. We have an excellent public health service, although the Deputy used language like “extracting wealth from the public services” and she said the Government is “officially” in favour of Sláintecare. We are actually delivering Sláintecare as per the programme for Government, and I want to state that. I feel there is general commentary and a tone to the contributions that it is public versus private and that our public service is somewhat not to be trusted. That is not the case. We have an excellent public service, and I know Deputy Gino Kenny reflected that with regard to people accessing services. It is somewhat disappointing to hear Deputy Shortall in particular say the Government does not have the courage to implement Sláintecare. Deputy Shortall had an opportunity to participate in government and did not have the courage to see that through either. That is quite disappointing. Health outcomes are improving across all services, which has been reflected, although, again, Deputy Shortall referenced a case.

On the points raised by Deputy Murnane O’Connor around stamp duty, the Bill provides for a decrease in the age-related risk equalisation credits payable across approximately half of age groups over 65. These decreases are to facilitate the redistribution of high-cost claim credits which result in a more targeted distribution of credits based on health status rather than on age, which is a fair approach.

Deputy Boyd Barrett referenced the cost of living, coupled with the ability to retain staff in the health service. Again, while it is not related to this Bill, the Government has implemented a very significant cost-of-living package in budget 2023 that the ESRI assessed and found was progressive and targeted. The interventions we are putting in place are trying to support families in terms of the cost-of-living crisis we are facing.

Deputy Lowry raised points in regard to increased premiums and the out-of-hours services in Nenagh. I take on board those comments.

I thank the Deputies for their support for the Bill and their contributions to the debate yesterday and today. As was discussed many times throughout the debate, a large number of people hold health insurance. This is a choice for some while others, unfortunately, may view it as a necessity. The Government is fully committed to the Sláintecare vision of a universal single-tier health and social care system. Work is continuing within the Department of Health and the HSE to progress work on Sláintecare, and the Minister for Health and the Government remain fully committed to the continued delivery of Sláintecare reform.

Private health insurance policy aims to align progressively with Sláintecare reform objectives. A number of Deputies referred to the consultant contracts and moving this forward as being a vital step. The Government is committed to introducing a Sláintecare public-only consultant contract in a timely manner in the near future. This process is ongoing under a new chair agreed between the parties, Mr. Tom Mallon. When the date of the implementation of the new contract is set, the new consultant contract will apply to all consultant appointment offers from that date.

Various other issues were raised over the past two days. If Deputy Ó Laoghaire or any other Deputy with specific constituency queries would like to send the details to the Minister for Health, officials will look into the matter. A number of constituency issues were raised today by Deputy Murnane O'Connor and others, and I urge the Deputies to bring those specifically to the attention of the Minister for Health.

This Bill allows us to maintain our support for the core principle of community rating, which is long-established and well-supported Government policy for the health insurance market. The Bill will ensure we can continue to provide the necessary support to ensure the costs of health insurance are shared across the insured population. The provisions of the Bill increase the effectiveness of the risk equalisation scheme by reallocating credits based on age to credits based on health status in the form of high-cost claim credits without increasing the stamp duty payable.

Deputy Duncan Smith questioned if there is a policy decision on community rating and if it is still needed. The Government is committed to improving public health services under the Sláintecare programme and this Bill shows the Government is committed to community rating. As access to public services improves, the Department of Health will monitor the impact on the private health insurance market.

The programme for Government commits to retaining access to private healthcare services for people, ensuring choice for those accessing healthcare. The Bill continues our policy of ensuring solidarity with, and affordable premiums for, less healthy or older people. I commend the Bill to the House.

Comments

No comments

Log in or join to post a public comment.