Don Lydon (Fianna Fail)

Mr. Charles Haughey said once that the job of the Opposition is to oppose. I understand that the Opposition has to submit various motions on various topics. I would like to examine this motion in a little detail. While some of it is good, I want to make clear that some of it is not so good.

This debate was started by the Tánaiste's announcement in July of last year of an initiative that will provide private beds on the campuses of public hospitals. The aim of the initiative was to enable up to 1,000 beds in public hospitals which are currently used by private patients to be redesignated for use by public patients. How could anyone disagree with that? As a number of speakers have said, the initiative brings together a number of Government policies. Co-location is already a feature of a number of hospital campuses. The experience of the co-existing bodies will be taken into account.

The motion before the House "condemns the Government for pursuing a policy which will give away the lands of public hospitals to private hospital developers". That is not what will happen, however. As the Tánaiste said earlier in this debate: "Not one square inch of public land will be given away to anyone. Public land will be leased or sold at commercial rates in order to achieve new public hospital beds". That does not mean that land will be given away.

The Opposition motion also calls on the Government to "abandon its plans to give the lands of public hospitals to private developers". Lands are not being given to private developers. That is not what this is about. It is about providing 1,000 additional beds for public patients over the next five years.

I do not believe anybody in this country doubts the Tánaiste's bona fides. When she took on the role of Minister for Health and Children, which is one of the most difficult ministries, she went straight at it in a sensible and rational way. As she knows she cannot fix everything in a week, she is planning ahead. She has adduced her plans and made radical changes so far and will continue to do so. She is determined and intelligent and she will get the job done. It might take her five years to do it, but I am sure she will continue her work over the next five years. While she might change her portfolio, I hope she will still have the same job after the next general election.

The Tánaiste mentioned many of the advantages of her approach in her speech. It encourages the participation of the private sector in generating extra capacity and maximises the potential use of public hospital sites. I know of many hospital sites where many acres of land were not being used. They were lying vacant without any plans to build on them. This measure will encourage such construction.

The Fine Gael motion says that public lands should be used "to build much needed public health facilities", to provide "more in-patient beds" and to make "more step-down and rehabilitation facilities for the elderly" available. That seems laudable until one remembers that 1,000 more inpatient beds are being provided. I must confess that I do not know whether more step-down and rehabilitation facilities for the elderly will be made available, but such facilities may well result from the Tánaiste's approach.

The additional revenue cost to the Exchequer of 1,000 beds is the result of having to replace the income lost by public hospitals in transferring private work to the new private hospitals and a small increase in consultant numbers. The staffing of the beds will remain in place in the public hospitals, there will be no change in that. The tax foregone in relation to capital allowances in respect of investment in private hospitals is available whether private hospitals are on green field sites, hospital campuses or elsewhere. The tax breaks are the same.

What is the advantage of this approach? The two hospitals will be located together. The transfer of staff, expertise and training will be linked. That is what it is about. I do not want anyone to say there will not be a link because there will be. Doctors will move from one facility to the other, etc. To provide 1,000 hospital beds in public hospitals would cost the Exchequer in excess of €500 million capital and €300 million revenue per annum, but that will not happen in this case. I do not need to restate the figures the Tánaiste gave in her speech, but I will do so:

If the public sector builds 100 new beds at a hospital, the full capital cost must be met from the Exchequer, which is approximately €100 million. However, if the private sector builds the new facility, the capital cost to the Exchequer is reduced to a maximum of 48% with full capital allowances used.

How could one not agree with that? This is a good deal. Any businessman who looks at such a deal would say we are getting more beds for half price, or almost nothing. We hear complaints about the scarcity of beds every day, but we are providing them now in this way. I cannot understand how anyone can attack the Tánaiste, who has the backing of the Government in this regard, for her plans.

The only aspect of the Opposition motion that is important is the reference to meeting the need for "more step-down and rehabilitation facilities for the elderly". We are not discussing such services, but I am sure they will be provided. However, the main thrust of this motion, about giving away land, is somewhat disingenuous. It is good that the Opposition opposes by tabling such motions, because it provides an opportunity to put the real facts before the public. The Health Service Executive has advertised and has received many expressions of interest in this regard.

There is a philosophical argument to the effect that we should not have private medicine at all and that everyone should be catered for by the health services. While that is all very well, I ask whether a single Member on the Opposition benches does not have insurance from VHI or BUPA? Members should be frank.

People will use such facilities, if they exist for private care, and in the meantime, public hospital beds will also be available. Moreover, this initiative will provide an opportunity for a value for money assessment of any proposal. It will take account of all developments, as well as the cost of the tax expenditure and so on. In addition, there will be full adherence to public procurement law and best practice.

When one listens to debates on such matters without going into details, one might come to believe that the land is simply being given away and that some developers will buy it to put money in their pockets and so on. Of course such developers will make a profit. While people assert that profits should not be made in health, there is a profit to be made in this sector. It is usually ploughed back into the services and I do not see anything wrong with that. I see a need for beds and I see the Tánaiste providing these beds through a unique scheme. She proposes to use land that was lying derelict, not by giving it away, but by selling or leasing it on normal commercial terms. She is to be lauded and praised for this initiative, and not condemned.