Maurice Cummins (Fine Gael)

I welcome the Tánaiste. Many consultants and developers have come together in many parts of the country to build private hospitals mainly because of the tax breaks which emanated from the 2002 and 2003 Finance Acts. My colleague, Senator Browne, alluded to the fact that for every €100 million invested, the taxpayer will contribute €42 million. This is a massive gift from the taxpayer. The State will not own one brick in these hospitals. This may seem a bad deal for the taxpayer but to have a policy where private hospitals can be built on the land of existing public hospitals is a step too far. As Senator Quinn mentioned, this land may be required for the development of public services in the future. Did the Tánaiste consider that when she announced her policy?

This policy deserves careful scrutiny not alone by the Houses of the Oireachtas but by the Comptroller and Auditor General before any further commitments are made on it. This is the people's land and should be used for public beds for the people. We need more public beds, especially step-down beds, particularly in Dublin. My party has made it clear that lands in public hospitals should be used to provide public health facilities. The State lands should not be given to the developers of private hospitals.

The key to public private partnership initiatives is that the risk is genuinely transferred to the private sector. There will be a 42% subsidy for the hospital buildings and 20% subsidies for their operation. I doubt they will provide accident and emergency departments. All the routine work will be moved to the private sector, the most lucrative area within the system.

It is estimated by investment promoters for these projects that every €75,000 invested will yield a cash profit of €62,000. This will go to high income earners, particularly those with large rental incomes. No wonder this proposal is being presented as an attractive property deal. Will the Tánaiste spell out whether separate facilities such as laboratory services, x-ray services, CT and MRI scanning facilities as well as intensive care units will be provided in these for-profit hospitals adjacent to our public hospitals? If the public facilities continue to be used for private patients the public patients will have to wait longer for diagnostic tests and procedures.

Despite the Tánaiste's plan to introduce public-only contracts for hospital consultants she recently stated that consultants in public hospitals will be allowed to treat their private patients in the new private hospitals. Will this also mean that the private consultancy rooms they occupy in public hospitals will also be transferred to the private hospitals?

Studies in medical journals have demonstrated that for-profit care is expensive and the health outcomes compare unfavourably with those for non-profit care. The plan to have private hospitals on the grounds of public hospitals makes neither good health policy sense nor economic sense. There is a fundamental difference between building 1,000 new public beds and the plan which the Tánaiste has announced.

The not-for-profit governance model for acute hospitals in Europe is based on a commitment to patient care rather than profit. Dr. FergusO'Farrell recently suggested that such a model is cheaper for the taxpayer, will lead to better care for all patients through a single high quality standard of care provided by the same health care teams within one hospital.

Market forces seem to dictate everything nowadays. Dr. O'Farrell says some aspects of life, such as care for the sick are too precious to entrust to the market. The Minister has failed to solve the crisis in accident and emergency units although she has been in office for some time. This policy will also result in failure.