John Crown (Independent) | Oireachtas source

I second the amendment. I agree completely with the sentiments expressed by Senator Barrett. The HSE is a failed experiment. The notion of having a single, nationally commanded and controlled managerialist bureaucracy micro-managing every aspect of our hospitals and other parts of health system has failed. We need to hasten the model's extinction. Many people, on hearing this argument, will think that the only alternative is to have a rigid, Darwinian, laissez-faire, winner-takes-all health system based on the survival of the fittest and not on social solidarity. This is not the case, as the Minister knows.

We all believe health care should be delivered according to the principle of social solidarity, with the better off subsidising the health care of the less well off. It should also be based on the principle of access based on need and not on the ability to pay. What often gets lost in the fog of debate is the fact that there are other ways to this nirvana. Not all of them involve going through a Byzantine, unitary national bureaucracy. If one considers the ranking of OECD countries' access to health care, one will note that those countries ranked in the top ten follow the alternative model, one which is based on insurance. When people use the word insurance, they become terrified because they believe it is a question of only-for-profit insurance companies. We believe the principle should involve a mixture with some for-profit insurance companies and some not-for-profit social insurance companies of the type that exists in many countries, such as Canada, Germany and Israel. In truth, this is the type that exists in this country in the form of the VHI.

In seeking to impose the deadline, we are aware that the Minister will be an axe-wielding huntsman looking for appropriate bureaucratic targets to decapitate on the way to achieving our ultimate insurance-based feast. However, he is surrounded by turkeys who will try to delay Christmas. We are just trying to sharpen the Minister's blade.