David Cullinane (Sinn Fein) | Oireachtas source

It is constructive to set out a vision for health care and it is relevant to this Bill to do so given that it deals with regulating the system and risk equalisation. The Bill reflects the Minister's plans for the future of health care but we take a fundamentally different view. Ours is not a fanciful view. We believe health care should be delivered on the basis of equity, free at the point of delivery, funded through general taxation and available on the basis of need. We have developed a health plan and I can send the Minister a copy of our latest health policy document if he wishes to take the time to read it.

He appears to agree with certain parts of our plan. We apply the full cost of private patients in public hospitals. He is going some way in that direction in the budget so that taxpayers do not have to subsidise private health insurance. We also call for savings to be made on drug distribution and use of generics. He has gone some of the way on that. I make no apologies for saying that we do not want consultants to avail of taxpayers' money to pursue private practice in public hospitals. That does not detract from the good work that all consultants do in our hospitals. The Minister was robust in arguing that consultant contracts needed to be renegotiated. I did not hear the same criticism from Senator Burke in regard to taking care with what we say about consultants when the Minister was doing the right thing in addressing the issue of consultant contracts, although that did not work out in the way he expected.

What he is trying to do here is unnatural and it will not work in the long term. The natural way to provide health care is as a public service funded through taxation and delivered on the basis of need. Private health insurance companies are solely motivated by profit. They are in this game to make money from people's need for health care. The Minister wants to open up our entire health care system to the private health insurance market but we do not want to see that happen. We are not alone in taking this attitude. I read with interest the IMPACT analysis of his plans for the future of the health service. It was scathing of the way in which the health care system in the Netherlands created a more inequitable and inefficient system of health care. The Minister can shake his head but I am entitled to my view.

I am not obsessed with inputs. I believe we must change work practices and that we must create health care settings where all health care professionals can provide the best health care possible. They are doing a Trojan job in difficult circumstances, despite all the cutbacks and reductions we have seen in wards, theatres and staff, and are trying their best to provide the best health care possible. We must also create greater efficiencies. The Minister may remember from his time in opposition that we have called for a health funding commission to be established to look at where we spend money in the health system and where money is being wasted so as to ensure we spend taxpayers' money on delivering frontline services rather than waste it on administration, branded medicines or on subsidising private health care.

That is our vision of the health service. It is obvious the Minister does not intend to accept our amendment, but I will press it.