Deirdre Clune (Fine Gael)

I am glad to have an opportunity to speak on this Bill. As was stated, it is just a technical Bill extending for another 12 months the circumstances that have obtained since 2009. As every Senator has been saying, the Minister of State's contribution was very comprehensive. It certainly gives the background to where we are today, and the reasons therefor.

I support many of the comments made on health care and the need to introduce efficiencies and reduce costs. The VHI has been mentioned by many speakers. Senator Burke mentioned the current circumstances in Cork where the VHI is not extending cover in respect of a new hospital proposed to be opened by the Mater. This decision reduces competition. One provider in the Cork region provides about 88% of private health care in the region. In Dublin, no hospital provides more than 25% of the private care available. This suggests a lack of competition in Cork.

I question why a provider in the Cork area could refuse cover regarding a certain hospital. Surely if one buys one's own private health care, the money should follow the patient. A patient, when covered, should be accommodated by the health insurers.

I refer to a situation in my own area when a Dr. Pillay tried and failed to open a private hospital in Cork in the early 1990s and, therefore, people in the Cork and Kerry region do not have a choice and there is no competition in the market in the area. The Minister, Deputy Reilly, spoke recently about the fat that needs to be cut out of the system. In my experience, the VHI does not seem to be proactive in its dealings with hospitals in order to reduce costs and much more could be done in this regard.

I listened with interest to the Minister's comments regarding private beds in public hospitals. The Minister of State, Deputy Shortall, has previous experience of this issue when she, like me, was a member of the Committee of Public Accounts. The 80%-20% rule applies by which only 20% of beds in a public hospital are available for private cover. As the situation stands, if this figures goes over 20%, the hospitals cannot look to the private health insurer for that cover.

The Minister has proposed changes in the budget. I hope there will not be a temptation on the part of the public hospitals to bring in more private patients. It might suit them to increase the ratio to 30% which would mean taking away public beds. It is a question of who will police this practice and it is open-ended as it stands. Private hospital care is not available in all regions. There is no private hospital in the Limerick region and the public hospitals consistently have more than 20% private beds. This is a concern. I am pleased the Minister has addressed the question of universal health care and its introduction is crucial. The money will always follow the patient and hospitals will find it in their interest to deal with patients who carry insurance. Universal health care is a progressive policy and it will take time to put it in place.

The Minister of State is directly responsible for the primary care system which plays a crucial role in reducing dependence on acute hospitals. The primary care system is being developed slowly across communities. I can quote three centres in my own area which have been developed and they have the support of the local GPs. They are providing a range of health care to the community with the ultimate aim of reducing our dependence on acute hospitals. This Bill is a technical measure to extend the existing provisions. The ultimate aim is to provide efficient health care on an equal basis to all citizens.