John Crown (Independent) | Oireachtas source

I know we are working to a timeline and perhaps I misunderstood how the Order of Business was to run. However, there are a few points I want to make, more on the general tenor of the Bill.

When I heard my colleague talk earlier about the evil markets, I was reminded of the comparethemarket.com advertisement, on which the little meerkat accused people of confusing the term "compare the market" with "compare the meerkat". There is such a problem like in this instance. There is an assumption that markets always mean "for profit" and Darwinian survival of the fittest and starvation of the poorest. While I am sorry my colleague is not present to hear this, he needs to understand the market in many parts of the world is a socialised one. The idea is that market forces are brought to bear which allows patients to have a choice in where they go for health care, what doctors they see and institutions they attend. These patients are equally empowered by the possession of a uniform insurance instrument which gives no citizen an advantage over any other in terms of access to health care and obliges every hospital and doctor to regard patients equally because of this solitary transferable insurance instrument. That is the system in Israel which has a number of not-for-profit health systems that compete against each other. It is the system in place in Canada where there is one provincial health insurer to which everybody has access. It is the system in place in Germany where a mixture of public and private insurers provide a generally uniform insurance instrument for citizens who can use it to freely negotiate in any part of the health system they wish to attend.

Her Majesty's United Kingdom National Health Service, so beloved of colleagues here, consistently ranks among the poorest performing health systems in the developed world. That is a fact. Many have a misty-eyed, nostalgic love of the NHS because it was born of a wonderful egalitarian impulse in the grey bomb-strewn ashes of the post-Second World War United Kingdom. However, it has not moved with the times and instead perhaps owes more to the philosophy of Stalin in the way it actually delivers services than it does to a more modern approach. It consistently has the worst cancer survival rates and the longest waiting lists. In fact, if it was not for Ireland, the United Kingdom would have the longest waiting lists in the world. If one looks at a league table of OECD countries in terms of access to care, one striking feature is that the top five countries all use the alternative model - still socialised, still responsive and still based on need, not ability to pay - which is the Bismarckian model of a uniform insurance instrument. This is the model I know the Minister intends moving towards and it is the one we need to move towards.

I would like to finish with some quick points. We have heard much said today about consultants. I specifically came into this Chamber not as an advocate or defender of consultants and I have not tried to represent that constituency. However, a few facts need to be in the public domain.