Sean Barrett (Independent) | Oireachtas source

We asked for an independent referee and, obviously, the Minister does not want to concede that request, given the record. It is good that Ireland should be compliant with European Union law in these matters and not further bias the market.

We have the Milliman report, which has 31 pages of redactions in a total of 67 pages, and it shows repeatedly that the VHI problems are caused largely by itself. A table on page 31 indicates that an average length of stay in a VHI bed is 10.6 days whereas in a well-managed system it should be 3.7 days. For surgical procedures the VHI pays for 7.5 days but in a well managed system the length of stay should be 3.7. On page 33 the report states: "We found little evidence of any attempt by VHI to control hospital utilisation effectively....". The report states on page 36 that VHI has focused a great deal of management time and resources in assessing the contribution of the risk difference in its claims caused by its old people and neglected efficiency issues. That is all in the report the Department has had. We rely on competition to get those out of the system, not requiring the new entrants to compensate the old people.

I thank our colleague, Senator Colm Burke, who raised very interesting points on this issue, that VHI and the system in general has to address costs. It reminds me of the Aer Lingus monopoly days when there were all sorts of Government Ministers appealing to Aer Lingus to do A, B and C. Competition achieved it far better. To require the new entrants to compensate the incumbents on grounds which are disputed both in Oxford and in Kings -there is something in what the Minister said but not the obsession which this legislation encompasses and which has been the obsession of VHI that in some way all its competitors have cheated. I recall the 50th anniversary of Ronnie Delaney winning his gold medal when one of the competitors said, "If you can remember this buy some health insurance." There are many other ways the Minister could have addressed that problem if it was a problem. He could have taken inducements from the VHI to transfer its older members to the new entrants. He could have asked the new entrants to recruit a certain ratio of old people to its younger recruits. He could have had an ombudsman as in car insurance where young people who used to be refused cover could go to the Department and get the cover. To assume that subsidising VHI more is the only solution to the problem is wrong.

On the Supreme Court case which is the one I quoted, which in turn had a quote from the High Court case, the verdict was 5-0 against the Department.