Colm Burke (Fine Gael) | Oireachtas source

I thank the Minister for coming to the House to deal with this matter. I note the comments made by Senator Barrett about the amendments. Regarding amendment No. 4 he is talking about the Central Bank having a role. I would have no objection to that but it is not appropriate in this case. It is something that should be examined in the long term.

I had my own difficulties with VHI in the past 12 months. I was surprised to find in a submission to the Joint Committee on Health and Children by the VHI that there was only a 60% occupancy rate of private beds in the hospitals in Cork. I found it difficult to understand that figure. I found it difficult to understand VHI's decisions in regard to competition in Cork. I agree with Senator Barrett that there is a need for competition in the health insurance area but when we consider the current age profile of VHI members it does have the vast majority of the age group over the age of 65.

The Senator referred to the cost of health care for the elderly. It is interesting that the recent statistics in the Health in Ireland Key Trends 2012 report show that the over 65 age group had a 49.2% occupancy rate of hospital beds which is a clear indication that our health care system is providing comprehensive health care for people over the age of 65.

An issue that arises with older patients is that on many occasions they will occupy a bed for a longer period than the average person. I note that the average occupancy rate in our hospitals has reduced slightly from over six days to under five days per admission. In the older age group that occupancy rate is a higher number of days, therefore, there is a higher expenditure level and a higher demand on the insurer.

On the health care area, it is interesting to see how we have moved forward in recent years. There is a great deal of criticism of health care. It is about making it more efficient because if we make our health services more efficient we help to reduce the cost of insurance. It is interesting to note that the number of day procedures has increased from over 353,000 to over 881,000 per annum. Over 60% of all procedures in hospitals now are day procedures, which is a welcome development.

It is interesting to note also the increase in the number of outpatient attendances which has gone from over 2,185,000 per annum to over 3,583,000 per annum, which is a huge increase. That means that follow-up and access to hospital services has increased dramatically.

There is a great deal of criticism of the health care system, some of it justified and some of it exaggerated but people are not looking at the bigger picture in terms of the numbers of procedures being performed that have increased dramatically in recent years. If we increase the level of hospital care we also increase the level of demand on insurance companies. That is one of the issues that arose in the debate in Cork. If we increased the number of beds available for private health care there would be an increased demand on the insurance company. The speed of the delivery of health care must be increased because that will result in a saving in the long term.

In dealing with the health insurance area we must have much more planning in terms of the way people look after their own health. Rather than looking after their health when a problem arises they should look after their health to prevent problems arising. I am not sure we are doing enough in that regard. They have done an audit on that in one European country which allowed people access to health care in terms of providing a full audit of their health needs. In that way problems are identified at an early stage and that results in a huge saving.

We need to do a lot more on that. The figures produced in the recent study, Health in Ireland: Key Trends in 2012, show that the consumption of alcohol and smoking trends have not changed dramatically. All the work being done in heath care is negatived given that not enough is being done in the area of alcohol and smoking. That is something that needs to be done in forward planning.

In regard to Senator Barrett's amendment which seeks that the Central Bank of Ireland shall conduct an annual actuarial analysis of the health insurance market, that is something that needs to be done. I do not know if this is the appropriate Bill to deal with the issue. However, there is a need to keep a careful watch on value for money from the insurance point of view especially when moving forward to universal health care. That is another reason to ensure we get value for money from the health insurers. We must ensure that those who provide health care also give value for money and that moneys are being spent unnecessarily when huge savings could be made. There is a need to far more cost effective in that area. Obviously the Minister will respond to the amendments. If amendment No. 4 is not dealt with under this Bill it is an issue that should be examined for the long-term.