Feargal Quinn (Independent) | Oireachtas source

I move: "That the Bill be now read a Second Time."

I welcome the Minister for Health, Deputy James Reilly, to the House. We are getting to know him here as he comes in on a regular basis. I hope he will welcome the Bill.

I produced this Bill to address concerns which I have had for some time about certain aspects of the health insurance sector in Ireland.
There are features within the health insurance sector as well as surrounding the regulation of the health insurance sector which make me uncomfortable. Special treatment for one provider over all others and conflicts of interest at the highest levels are not features of a fair and equitable health insurance sector where the consumer is prioritised above all other considerations. Quite frankly, under the current arrangements the consumer comes a definitive last.
The Minister for Health currently stands in the position of being the shareholder and largest provider of private hospital services in the market through the HSE. The Minister is also the shareholder of the largest health insurer in the market, VHI, and he also has responsibility for regulating the health insurance sector – exercising wide-ranging powers that have a direct impact upon both the HSE and the VHI. By any measure, that is an unhealthy set of circumstances.
The fact that the VHI is not subject to the same regulatory or solvency requirements as other health insurance providers in the market is also untenable. It is not a matter of choice. The Government is required to give effect to the decision of the European Court of Justice in the case of European Commission v. Ireland.
The purpose of this Bill is to introduce reforms in three areas of the health insurance market. First, the Bill provides for the transfer of the responsibility for the management of the State's ownership of VHI to the Minister for Public Expenditure and Reform. This proposal is designed to bring about an end to any actual or perceived conflict of interest that comes about from the fact that the Minister has to wear a number of hats. This is a relatively simple, but yet important, proposal.
Second, the Bill seeks to normalise the regulatory position of VHI by requiring VHI to meet the solvency requirements that are applicable to all other health insurance providers in the Irish market. This proposal gives effect to the decision of the European Court of Justice. It is not a matter of discretion for the Government. Based on that decision, it must be implemented. The fateful day has been set and has been postponed on a number of occasions. We saw last week that VHI recorded a surplus of €65 million. It is time to cut the apron strings and let VHI stand on its own two feet. The least consumers can expect in an open and progressive economy such as ours is that the health insurance market is transparent and equitable. At present, I suggest this is certainly not the case.
Third, the Bill provides for the dissolution of the Health Insurance Authority, HIA, and the transfer of its regulatory functions to the Central Bank of Ireland. All other insurers in the State are regulated by the Central Bank. Why should the health insurance sector be any different? What I propose is that we dissolve the HIA and transfer its functions and expertise to the Central Bank. Not only does this proposal make perfect sense, it is also consistent with the Government's commitment to reducing the number of public bodies in existence. Some time back, a former Minister for Health asked me to get involved. At the time, I was not able to do so. I could not believe the number of quangos and different organisations, some of which were in the same town doing the same thing. I believe there is a need to reduce their number.
As those of the squeezed middle continue to be forced to abandon their health insurance, and as the cost of health insurance continues to rise year after year, we as legislators must act to bring some sense to this situation. We can no longer tolerate a situation where, time and again, the welfare of VHI outflanks the welfare of the consumer. That is unsustainable.
It is time to normalise the regulation of the entire health insurance market. There can no longer be any favoured health insurance provider. If that means the State must divest its interest in VHI or attract further investment, then so be it. I am fully supportive of the State maintaining control over key public utilities, such as water, electricity, public transport and, indeed, air travel – certainly, air-traffic control anyway - but a case can no longer be made for the State's continued ownership and control of a health insurance provider.
I would ask the Minister to reflect on what I and my colleagues have to say here today and accept that the status quo in the health insurance sector can no longer remain, and to not oppose the passage of this Bill. There are three parts to it. I believe each is worthy of consideration, approval and support, and I urge the Minister to do so.