Danny Healy-Rae (Kerry, Independent) | Oireachtas source

I am glad to have the chance to speak on this important matter. The Bill is regarded as pivotal legislation in the ongoing effort to fine-tune risk equalisation credits and stamp duties within the private health insurance market. It does absolutely nothing, however, to reduce the cost of private health insurance. In fact, it is more about helping insurance companies than it is about doing anything to help people with the challenges of the affordabilty of health insurance or the escalating cost of the public healthcare system.

As I have said before, insurance companies have been doing exactly what they like since Seán Quinn was forced out of the insurance market. He provided competition and made insurance available, even in the motor industry. He insured young fellas who were trying to get on the road and for whom insurance was unattainable before that. Likewise, he was helping in the private health insurance sector as well.

The Bill does nothing to reduce the cost of private health insurance. The cost of the average adult policy has increased by at least 5% since last year. Year on year, it is going up 5%. Many people have contacted me to say that even if you have health insurance, you will have to wait six months to be seen, which is ridiculous. Even people with health insurance have to wait six months. We all know that cancer can go from stage 1 to stage 2, 3 or 4 very quickly if it is not challenged or treated. The sooner it is treated, the better. People who have tried to pay their way and who pay for the health insurance are not even being seen by a doctor. Something has to happen.

We have all heard of people who have been found unconscious, brought by ambulance to a hospital and put on a ward. When they come around, it is invariably the case that the first question they are asked is whether they have health insurance. Maybe the Minister of State sitting opposite does not know why that question is asked. It is to ensure the HSE gets the maximum payment for each patient. The patient has to sign a form. Instead of the HSE getting €70 or €80 for each day of a stay in hospital, it can bill health insurance companies something like €800 to €900 a night for that patient. Is it any wonder health insurance is going up? It is all a merry-go-round. The HSE charges much more to the health insurance companies than it would if it was asking the private person to pay the bill, but the level of care does not go up. That is one of the reasons the cost of health insurance is increasing. Another reason, of course, is that there is no competition in the market.

The private health insurance market, which opened to competition in 1994, features three major providers, VHI Healthcare, Laya Healthcare and Irish Life Health. Market data highlights 3% of growth in the market during 2022, with 79,553 more insured individuals compared with the previous year. The total premium income for 2022 reached €2.9 billion. As of June 2023, 47.6% of the population, or 2.46 million people, held health insurance, with the average adult policy priced at €1,509, reflecting a 5% increase this year. The tax relief in respect of health insurance resulted in €355.3 million of forgone taxes in 2019.

In 2022, the Commission on Taxation and Welfare suggested phasing out this tax relief as part of the ongoing implementation of Sláintecare's healthcare reform recommendations. God almighty, when is enough enough? This is something that I and many TDs in the Minister of State's own party do not support. It has to be halted. Our group is adamant that the tax relief must remain because if not, many people will not be able to afford private health insurance.

The Health Insurance Authority not only serves as the regulatory body overseeing the private health insurance market but it also gives essential advice to the Minister for Health on health insurance matters, including duty and the risk equalisation scheme. In a concerning trend, Irish Life has announced its third price increase in the past 12 months, with the latest surge of 4.8% to be implemented in January 2024.

It is very clear that the health insurance system we have is not effective. There is not enough competition. The story is that health insurance is not helping people who even have it because they do not get any reward for having it. They have to wait six to 12 months, the same as people on the public waiting list. That is not right. I do not begrudge the people on the public waiting list. They must be seen after as well. However, the people who are paying are not getting any reward for it.

I have another matter to raise with the Minister of State, of which he is likely to be aware. HSE management and administration-grade staff in the Fórsa trade union commenced industrial action on Friday, 6 October. Unfortunately, one of the areas affected is the processing and answering of parliamentary questions and representations. This is hurting me and every other public representative, especially in the area of home help. I had a simple request, on or about 7 or 8 October, related to a case where the woman of the house is seriously ill. The family has pulled out all the stops to try to assist her. She always got up between 8 a.m. and 8.30 a.m. She is after getting notification that the home help will not come to help the family member who is staying at home to get her out of bed until 11 o'clock and the home help will not come back again until 5 o'clock in the evening. What the family is saying is that spending this amount of time in bed is not good for her. The day is too long from the time she goes to bed in early evening until the time she gets up in late morning. It made a very simple request. Have I got an answer about the case since? No, and that is not fair. I am asking the Government to deal with whatever gripe, grudge or concern the staff have. They are saying they are not being recognised or being paid for the grade they are working for.

There is another thing, and this is a fact. I will call it out one of these days if it is not sorted out. I have been reliably told something by the home helps, who will not leave, and I have to compliment them as they do their work so diligently. However, they have been told by their manager that they will not be paid for the overtime they have worked. They helped the people who went off sick by taking their places because they did not want to see the patients short-changed or not seen after. They went to help their comrades who were off sick or had to go somewhere. Then they were told by the manager that they were not going to be paid for the overtime. There has been a lot of talk in this Chamber about trying to keep people in their homes for as long as possible and they save the State a fortune when they do not go into hospitals.

I am asking the Government to sort this out. It says it has funds and it gave the HSE more funds the other day. Someone has to be responsible and call them out for what they are not doing. They are not helping the patients and in the healthcare system in many parts of my county, people are being short-changed. I have a lot more to say. When the motion is discussed later on I will highlight a couple of other very serious issues because the care of our elderly people is of paramount importance.

See this speech in context