John Crown (Independent) | Oireachtas source

It is good to be back. Clearly, the most important, and from the point of view of the average citizen of the country the most far-reaching, development in politics and public governance over the summer was the announcement that the long-promised cup of health service reform has been dashed from the lips of people campaigning for this reform for many years. I have been campaigning for health service reform for 20 years. I lived through the old Department of Health, the HSE, the health boards, the Eastern Health Board, the regional health authority, the diversification of administrators and the centralisation of administrators, but every time there was a failure actually to grapple with the fundamentals of reform, something we need to do if we are to bring in a health service which addresses the three core issues of the health service, namely, its generally poor quality - it is not terrible but it is mediocre and not as good as it should be for a modern and fairly affluent north-western European country; its extreme degree of structural unfairness in the way it has been designed; and the extraordinarily inefficient way it wastes precious health service resources.

For those who are of a fiscal rectitude bent I have said before and I will say it again that our health service is not underfunded particularly, although it is in some areas; it is malfunded. The funding of the health service is applied in a way which does not encourage equity, quality and efficiency so we do need this reform. It was for this reason I felt I had had a near religious experience when we had an aspirant Minister for Health, who had a realistic prospect of ascending to the office prior to the last election, stating that regarding the policy of the incoming Government, one of the five Fine Gael points was that there would be a specific reform of the health service aimed towards the introduction of a model based on universal health insurance, which I hope to modify a little and get it more interested in universal social insurance. Is that bell for me?