Duncan Smith (Dublin Fingal, Labour) | Oireachtas source

The Labour Party will be supporting this legislation, as we have previously. Risk equalisation, which the Bill provides for annually, ensures costs will be constant across a lifespan for an individual. It seeks to ensure that, where possible, age, gender and health status will not influence the cost of an insurance product.

Let me be clear, though. Our support for this Bill is not an endorsement of the current two-tier system, where so many people are reliant on private health insurance for their basic health needs, with the cost burden that is attached to that. The level at which people are reliant on it is reflective of a wider problem that we all can see in our health system and which was acknowledged in the previous Dáil with the special committee which ultimately agreed Sláintecare.

We must ask why so many people find themselves with little option but to fork out substantial costs each month for private health insurance. The answer is obvious. It was discussed today on Leaders' Questions and, indeed, this morning, with the Labour Party's motion on healthcare staff.

Hospital waiting lists remain unacceptably long and patients are waiting months and years to receive care through the public system and facing long stretches of time in emergency departments. In short, many people do not have faith that the public system can meet their health needs. Decades of mismanagement of our health system have brought us to this point and the delivery of Sláintecare and its goals has slowed to a crawl.

Most people in the country who understand and are engaged with the health service are 100% behind Sláintecare. As Deputy Cullinane has stated, we have seen the benefits of a universal system with the NHS in the UK, although it is not without its problems now, as the Deputy recognised. People want to see Sláintecare delivered but are losing faith that this Government can do so. To be honest, I think the people are losing faith that any Government can do so effectively, and that is a challenge to us all. They do not see the required staffing levels coming through or the levels of student intake that are needed in our third level institutions. Of the students who are graduating, we are seeing too many go abroad to work. Instead, they see a Government that is struggling to fund the HSE and our health service adequately, given our population increase and the demands on such

The healthcare staff who are coming through and are deciding to stay and dedicate their careers to the Irish health service are struggling to afford to live in the country; they are struggling to afford safe and secure long-term housing, either through purchase or long-term rentals. The reality is we are not retaining enough of the people we are educating. We are having difficulty retaining anyone who is entering our health service at any level, either through FETAC or degree level.

Private health insurance, as I have stated, cannot become a synonym for good healthcare. However, this is quickly becoming the perception and, in some instances, a reality. There is a huge issue in communities all over the country whereby people facing mental health issues and parents of children with mental health issues are being told to go private due to the extensive waiting lists in the HSE. They then learn almost immediately that their private health insurance does not cover the particular service they require in the mental health sphere. Mental health is an issue this Government has not given due priority to. As I stated this morning, and to repeat what was said to me earlier this week by a retired mental health worker, it has remained the Cinderella of our healthcare system. Access to mental health services cannot be a choice between a long waiting list or a huge cost in the private sector. Unfortunately, that is where we are now.

What we need to see moving forward is a real end to the recruitment freeze, adequate funding of our health service and real actions to deliver Sláintecare - a healthcare system that would be truly valued and trusted by the people. If that is the case, we will see a natural reduction in the number of people who are reliant on private health insurance and, we hope, people will get the care they need through a first-class internationally respected public healthcare system. Unfortunately, we are not there yet. Hopefully, we will be some day.

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