Sean Barrett (Independent) | Oireachtas source

I welcome the Minister and like other Senators, I heard his interview with Pat Kenny. One of the many good things in it was when he stated the sickness absentee rate among health service staff was now down to 4%, because that had been a scandal and I am glad it has been tackled. My metaphor for the health service, however, is that if I arrive in Heuston Station, I see a hospital across the road that is now inhabited entirely by bureaucracy. Between the mid-1980s and 2008, we doubled the number of staff in the health service from 55,000 to 110,000. It has fallen somewhat since then. Some staff have been transferred and there have been genuine productivity increases. I do not know what we were doing at that time but as for the appetite for more spending, more staff and staff in hospitals getting on to their politicians to claim the service is seriously underfunded and so on, we have had such a diet for quite long enough. According to the Department of Health's annual report for 2010, Health in Ireland: Key Trends 2010, the facts are that Ireland is a major spender on health services with expenditure of €3,793 per head of population. This is more than Australia, Belgium, Denmark, Finland, France, Germany, Sweden, Japan and Spain. I believe the Minister has real resource allocation issues in respect of how the system is operated.
I recall from the Milliman report that considered high VHI costs that we were keeping people who were insured by the VHI in bed for 11.6 days, against an average length of stay internationally of 3.7 days. That is a massive waste of expenditure and as the Minister noted in his speech, it is a danger to patients if they stay longer in that environment.
I support strongly the comments of my colleague, Senator Colm Burke, about the organisations that were funded by the Department of Health but which seem to have had a lifestyle most of us thought were reserved for the executives in Irish Water. I refer to the amount of alcohol consumption at a seminar to discuss liver disease and how the Department of Health has allowed these bodies to get away with it for so long, with people earning more than the Taoiseach while parading around as deeply concerned about the illness in question. It is necessary to get to grips with this budget because it is not a service that is starved of funds by the standards of any of the aforementioned countries. It is pretty good at making cases, putting patients upfront and saying these patients are dying because the Minister, Deputy Varadkar, or the Minister, Deputy Reilly, or whatever is the name of the Minister, is some kind of monetarist.
Members should simply look at the newspaper headlines stating pharmacists make huge profits from the State drugs scheme or Ireland has 50% more nurses than the OECD average. We passed the Health (Pricing and Supply of Medical Goods) Act 2013, which was to introduce a system of generic substitution and reference pricing, but what are the savings? While Members seek them now, as the end of 2014 approaches, that legislation was passed earlier. Members also passed legislation in order that the medical card list would be open to newly qualified doctors. However, Members asked the former Minister of State at the Department of Health, Deputy White, and I think probably less than a score of new doctors have been added. The local medical card doctor is a local monopolist and new people are not being allowed in. Banning new people from any activity is not a way to proceed.
Recent research by Paul Redmond that appeared on publicpolicy.iesuggests again that Ireland is among the major spenders on health services. As for some of the Minister's own figures, the expenditure on health per head of the population in 1999 was €2,000, whereas by 2008 it was €3,500. I do not believe the ageing explanation, as there is evidence it could be a red herring. People live longer and are healthier when they so do. One only dies once and the big health expenditure is in the last six months of life. However, I do not want that to be used as a cliche by the Department to have laxity in the way in which it considers budgets.
I hope we will not have yet another year of derogation for the VHI from normal health insurance. The briefing provided to Senators in this regard states that the European Union's third non-life directive forced competition in private health insurance on a reluctant Department of Health. It spent years postponing this and I believe health insurance should be regulated by the Central Bank as a financial service and there should be a level playing field. Competing health insurers should be able to tell the Minister and me that they charge cheaper premiums because they get a better deal. The cliché in the Department of Health, supported by the VHI and by additional levies on the rest of us, is that the VHI's problem is its members are too old. That is not the case. If someone can tell the Minister and me that they will insure both old people and young people more cheaply then VHI, that should be allowed to happen.