Frances Fitzgerald (Fine Gael)

I accept what the Minister of State said but if need were the determining factor the Government would have ensured more public beds were available. What we need is public beds, not beds in a co-located hospital. If the idea was to respond to the need for access for all in an equitable way, surely the way to have done it would have been to fulfil the promise regarding new hospital beds that was given in 2002.

The other method by which the Government has dealt with this matter is by means of the National Treatment Purchase Fund. This was originally launched as an emergency measure but more funding was added this year and in excess of 75,000 people have been treated to date. One cannot decry the reduction in waiting times for public patients but this comes at a huge cost to the taxpayer and may compound the two-tier system. The reason I say this is that it creates an incentive to treat patients on that list, as opposed to elsewhere. The HSE has already admitted that 35% of patients treated under the NTPF are treated by the same hospitals where they were awaiting treatment as public patients. This is a further demonstration of how the taxpayer is supporting private health care. The co-location proposal does not offer a solution to this problem but it can exacerbate it.

The health care system in the United States relies on the free market mechanism but it does not meet the principle of social solidarity, outlined by the Minister of State. People are not treated on the basis of need but on their ability to pay. Recent surveys in the official journals of the Canadian Medical Association and the American Medical Association have shown that treatment in private hospitals is more costly and that they have a higher morbidity rate.

The recent documentary from Michael Moore, "Sicko", highlighted the problems stemming from private hospital ownership, which included not offering patients necessary surgery because they were not financially viable. This reinforces the European view that we used to have in Ireland that public health is best served by hospitals remaining in public and not-for-profit ownership. Evidence has also emerged from an analysis of co-located hospitals that even within co-located hospitals, one can have a two-tier system.

I support Senator Feeney. We need far more discussion. I would like to see a paper from the Department of Health and Children on co-location which addresses all of these issues and which provides details of the impact co-location will have financially and in the longer term on the public health system in Ireland.