John Crown (Independent) | Oireachtas source

It was not named after the ship. It was named after the Iron Chancellor who in 1885 introduced what has become the longest, most durable, most successful, most resilient and most admired health system of any country. It is a system based on social solidarity, social democracy and treatment according to need not ability to pay. It is a system based not on the state running everything but on the state ensuring that there is a level playing field for everybody who comes into it. It is the model we need to emulate.

I ask the Minister to look critically at some of the way-station reforms which have been made in terms of things like hospital groups and national contracts and understand that the ultimate logic of where we are going with this is that many of the way stations will be obsolete and anachronistic. In the new dispensation, one may have very different kinds of doctors working. There may be doctors who are entirely private but take patients coming with their insurance instruments who would currently be called public patients. There will hopefully be doctors - I would love to be one if the opportunity arose - who are employees of a medical school and real professors unlike the situation we have now where we have nearly no one in that role. We may have some doctors who elect to work part-time in Government hospitals while others elect to work in partnerships with for-profit clinics. There will be different models available. What everyone will have is the same freely negotiable insurance cover. One can pick and choose the kind of doctor or hospital one wants to go to. In this system, large State-run hospital groups may not find themselves in a favourable competitive environment. The notion of having fixed national contracts for all doctors as if they all had the same unitary employer may not be feasible.

I wish the Minister well with his reforms. I am hopeful and confident that he will be in the chair he is in now to see through those reforms for the most part during the term of the current Government. It is potentially historic for our health service if these reforms come to pass. I ask the Minister not to waver, to keep pushing and to avoid being taken captive by the Civil Service.