John Crown (Independent)

Will the Leader ask the Minister for Health to come to the House to explain to us in the context of lengthy briefings he will give us on matters we wish to bring his attention what is the current status and the health of the VHI? I was giving this some thought recently. The single biggest catastrophe that could happen to the public health system would be if anything were to happen to the VHI that resulted in a large movement of insured patients back on to the waiting lists for the public system. I supported the new Government parties when they were still in opposition on the notion that they would reform the health system to a single tier, insurance-based mixture of private and social insurance, which is the synthesis of the Fine Gael and Labour Party documents. It is the same as the German model, not the Dutch model, and that is how they will get their reform. Germany has the best large country health system in the world .

I have previously expressed a little disquiet that the plan is for this not to happen until after another election. It is incumbent on all of us to advance that agenda because all the problems, pathologies and difficulties in the health system currently are not fixable in a most fundamental way until the inconsistencies at the heart of the system are addressed. Pending that reform, the financial health of the VHI, in which the Minister is the sole shareholder, is of critical importance and I would be grateful if he could give us a report indicating what his assessment and international expert opinions are about the current level of support for the company and, in particular, if there is a possibility that it is unusually sensitive to decreases in acute flow to meet its ability to pay for the services of its contracted members. Most other commercial insurance companies have endowment and investment to support them. I do not speak with authority on this and that is why I ask the question. Does the VHI have that or is it dependent on current revenues to fund the expenses it has incurred from past memberships? If that is the case, as the economy contracts, one could imagine a vulnerability in this regard.

I asked a few quick question of the Ministers of State at the Department of Health recently. Will the Minister of State with responsibility for disability, equality and mental health, Deputy Kathleen Lynch, get back to us regarding the number of psychiatrists in Ireland and how that compares to the UK and the rest of Europe as we attempt to make this great move from inpatient psychiatric care to community-based care?

Since I spoke on the issue of banning smoking in cars with children last week, I have experienced a tidal wave of support for an amendment. There is no necessity to sway public opinion on this in advance of legislation. A modest amendment to one paragraph of the 2002 Act could change this immediately and cost neutrally without debate. It would involve adding one minor amendment to the section that empowers the Minister to ban smoking in various places.

Will the Leader ask the Minister about the VHI and renew my questions about the other two issues? I urge him to consider an amendment to ban smoking in cars in which children are travelling sooner rather than later. There is no reason to delay that. Every month we delay means more children will be exposed needlessly to cigarette smoke in cars.