Colm Burke (Fine Gael) | Oireachtas source

I welcome the Minister of State to the House to deal with this matter. It is extremely important that there is risk equalisation.It is interesting that the Bill provides for risk equalisation for all persons regardless of age. For example, €3,300 per annum is paid from the fund to support a male aged 80 years or over with private health insurance. In the case of a female aged between 80 and 85 years, it is €2,475, and the contribution from the fund for a male over 85 years is €4,600. People of that age cannot afford that amount to pay for private health insurance but that is what they would have to pay for it. It would be beyond their reach and, therefore, the Bill is important. It is about giving equal treatment to everybody, regardless of age, with regard to the cost of private healthcare.

In fairness to the insurance companies in the market, all of them provide a good service. It is interesting that the number of people who pay for private health insurance has increased. We should also consider the contribution insurance makes. With regard to the HSE, approximately 3.2 million outpatients are seen in our hospitals per annum. That equates to between 63,000 and 64,000 per week. In addition, I may be off in my figures but to give an idea of the level of input from private health insurance, more than 2,000 consultants provide healthcare on their own premises. If they see an average of 20 people per week, that means there are a further 2 million attendances for healthcare. It would not be possible for the HSE to provide that unless there was a significant increase in the number of medical staff across the HSE.

As regards increasing the number of medical staff, it is important to be careful about how we fund healthcare and ensure we get value for money. I have concerns in that regard. Last week at a health committee meeting, I received figures on HSE employment. I note that the number of people employed has increased by 13,460 in the four years since December 2014. My concern relates to administration and management where the number has increased from 15,100 to 18,100. I have expressed my views on that issue previously. That is an increase of 3,000 in the number of people in administration and management. Likewise, in hospitals, the number of nurse managers has increased by 1,100 from 6,600 to 7,700. Additional staff are being provided but the question is whether we are using staff time and the work they do in an efficient manner. Can the increase in staff continue to be permitted without seeing a return in respect of the numbers going through the hospital service? We must be careful about that.

I agree with colleagues regarding the VHI board. Many complex issues arise for the board, ranging from the employment of staff to dealing with outside people across the healthcare sector whom the VHI board pays every day. It is important, therefore, that there is a range of expertise on the board, such as on legal matters, accountancy and cost effectiveness. The number on the board should be increased from five to seven. We must ensure we have a board that has the necessary skills to deal with management and the important decisions that are required to provide an efficient board. There must be value for money in the service it provides in respect of the care it is prepared to pay for and in the management of money. The VHI is not a for-profit organisation but it must collect a sufficient premia to discharge the claims that are made. It is important that there is efficiency through having a good board. My colleagues referred to how the VHI has changed over the past few years. They are welcome changes and long may they continue.

I welcome the Bill. It is important to retain risk equalisation and ensure that all parties are treated in an equal manner. That is what the Bill is about. Whether somebody is aged 18 or 80, he or she should be able to afford private health insurance if the person deems it necessary for his or her healthcare into the future.