David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I thank the Minister of State for all that. I also thank her officials for the work that has gone into this Bill. It is debated annually. It seems to be Groundhog Day in that we have the same discussion on it every year. It has to be done; it is going to be on our annual cycle of Bills. Its purpose is to review the risk equalisation mechanism. As the Minister of State said, it deals with the stamp duty levy on policies and risk equalisation credits payable to insurers for 2024. We support the substance of the Bill because of what it does.

When we have this debate every year, we need to reflect on why so many people have private health insurance. Many people will always take out private health insurance, possibly irrespective of how good or bad the public health service is. Many of them take out private health insurance because it is a comfort blanket and they cannot depend on the public system. Most people that I talk to who have private insurance – I do not – have it for elective procedures. It is to get care quicker. I very much hope that when we build the elective centres, the elective-only hospitals where we will have volume, there will be a lot of elective planned procedures. There are to be four centres: one in Galway, one in Cork and potentially two in Dublin. I hope the centres will separate scheduled care from unscheduled care.

I have spoken to senior people in the Department about this. The logic of the elective-only hospitals entails reform of healthcare with a big R because, in reality, they would take a lot of the private care out of public hospitals. Much of what is done involves consultants doing private work in hospitals. While this is profitable, it involves high-volume and necessary planned surgeries and procedures. If they are done at volume and on time, including in short periods in which people have rapid access to the types of treatments in question, I hope we can reduce the need for people to take out private health insurance. The tenet of Sláintecare was to have a public system with public-only hospitals. We are moving in that direction and more needs to be done. Not only that, but we should also make sure we have a truly universal system across the board. I recognise the moves we have made but we have to go further.

I support the Bill and its principle and thrust. I am sure we will come back next year and have exactly the same discussion and make the same points, possibly with the same amendments, but that is the nature of this Bill.

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