Michael McCarthy (Labour)

The Labour Party has yet to find €20 million to invest in a communications unit that can trot out untruths and fallacies such as we have just heard. We shall continue without the kind of spin-doctoring that has surrounded this Administration for the past four or five years.

The national health strategy initiated by the Minister for Health and Children, Deputy Martin, was inspirational. It seemed to address every possible aspect of a very ailing health service. Chiefly associated with that strategy were the principles of fairness and equality. Senator Ryan quite rightly pointed out that a major plank of the three main political parties represented in this Chamber centred around the provision of medical cards. That was not a mistake at that stage. If equality in the health service means anything, it should mean people have access to services based on medical need and a capacity to benefit from that care. No other reason should determine how or why somebody accesses our health services.

Greater effort needs to be made in tackling of inequality in our health services. We heard for a long time that our health service was two-tiered, but we are now hearing it is multi-tiered. Those on lower incomes have been treated to the bottom tier of the health service for a number of years. I refer specifically to the public and private health service mix, one of the essential features in the financing and delivery of our health service. In other countries with a universal publicly financed system, parallel private financing through private health insurance plays a much smaller role there than it does here. The rate at which people here have availed of private health insurance has accelerated during the last couple of years. Almost half our population now have private health insurance.

Another element of the national health strategy was the emphasis on hospital waiting lists. Many of the concerns regarding inequality about which we have already spoken this evening relate to that issue. The data available on hospital waiting lists are limited in that only those on the lists for more than three months are being taken into consideration. That creates limited data because it does not take into account the actual number of people on waiting lists. We must put greater focus on those lists.