It is now the case that unless people have private health insurance, they have no guarantee of a health service. Members have debated the Health Insurance Bills in both Houses of the Oireachtas in recent years but a stage is now being reached where every citizen will be obliged to take out private health insurance or they will have no guarantee of access to the service. That is not fair at a time when billions of euros per annum are being spent on it. While we are spending world class money, we are ending up with a second rate service.