Paul Lawless (Mayo, Aontú)

I welcome the opportunity to speak on this Bill. Health insurance reports show that the average premium rates rose by over 12% in 2024. Some plans even jumped by 25%, a quarter, for some individuals. The average adult premium in the country now is €1,800 - an incredible figure. The Health Insurance Authority is preparing to raise the levies again further by another 10% on insurance premiums. This is an enormous cost for individuals who are above the very low threshold for a medical card and find themselves grappling with this enormous fee every single year.

I would like to offer some positive suggestions. The Minister and the Government should take more proactive steps. The Government has a policy when it comes to smoking that it is going to tax cigarettes to the point where people will give up. I believe we are at that limit at the moment. What about the inverse? What about proactive policies, for example, tax credits for gym membership?

It would be good for one's health. It would be good for society, good for the Exchequer and good for the health system if the Government took a more proactive view of gym membership and supported gym membership across the country. Gyms are struggling with the cost of doing business, insurance costs and all of the other costs associated with it. I believe the Minister of State could introduce a tax relief for gym membership and also, potentially, tax deductions for gym equipment at home. These are proactive measures the Minister of State could take that would be a net benefit for society but also from the Exchequer perspective.

I want to raise as well the issues in relation to the National Treatment Purchase Fund, NTPF. The funding for the NTPF in 2017 was €17 million and this year it is expected to be €240 million. It is an incredible rise. While I believe the motives behind the NTPF are good and indeed many of my constituents have availed of it, there are significant issues in relation to the potential for a conflict of interest because of the issue of insourcing and, indeed, outsourcing. Insourcing is where the HSE and the hospital transfer patients from the public list onto the private list within the hospital, and sometimes with the same consultant. A question, therefore, arises. Are we incentivising a lack of productivity in relation to this? Also, who is managing this? Who is ensuring that we have good governance in relation to it? I was struck at the public accounts committee, PAC, recently when the hospital official was asked who is managing this and she said that the hospital operates on a basis of trust. It is extraordinary. There is €240 million of taxpayers' money gone into the NTPF and we operate on the basis of trust. I believe there is an enormous amount of work the Government must do to ensure that the taxpayer is getting value for money, particularly when it comes to insourcing and outsourcing. We have to ensure that we are incentivising productivity in the health system. There are huge questions in relation to this particular issue of transferring patients from the public list onto the private list and in some cases, the consultants themselves are over this particular issue. I ask the Minister of State to carry out an analysis of the productivity per hour of these arrangements on both the public side and the private side. It is important the Minister of State does that to ensure there is value for money here.

See this speech in context