Paul Gavan (Sinn Fein) | Oireachtas source

It is nice to see the Minister of State. I thank her for coming to the House. It is good to have this opportunity every year to debate a Bill like this so we can see where we are at with Sláintecare and the commitment all parties in the House gave to phasing out private health insurance and the private health sector, and to working towards a public universal healthcare system where people are treated on the basis of need and not how much money they have in their pockets.

The Minister of State set out what the Bill will do and we will support this, but a fundamental question needs to be asked as to why people take out private health insurance. I think it was Deputy Howlin, many years ago, after his first spell in Government in the 1990s, who made the point that it was only then that he realised that private health insurance exists and depends on a public service that fails. If the public service worked, why would anyone take out private health insurance? Unfortunately, that is more true today than ever. The vast majority of people take out private health insurance because they feel they need it, they cannot depend on our public system and if they or a family member gets sick, the fastest route to help them is through private health insurance, whether it is to get a scan, test, assessment, appointment or treatment. This is true, but the problem is that all those who cannot afford to take out private health insurance are left on public system waiting lists.

According to the most recent figures, 900,000 people in this State are waiting to see a hospital consultant and 200,000 of them have waited more than 18 months. That begs the question of where the delivery of Sláintecare is, which promises that people should not have to wait longer than four months for treatment, when 200,000 people in this State have been waiting more than 18 months, some of whom, in areas such as orthopaedics or scoliosis, are children. It is a scandal. Sláintecare will not happen until we make a commitment to properly resource our public hospitals, recruit the consultants, specialists, nurses and healthcare assistants we need, and to have public beds in public hospitals.

I have to mention the situation in University Hospital Limerick, which continues to get worse, unfortunately, month after month. The typical number of people on trolleys in that hospital is now 85 per day. We know further investment is coming but, having met hospital management, we know there is currently a 200-bed shortage. We know that the next set of promised beds will not arrive for at least another two years. When they do arrive, instead of the 96 beds that were promised, it will actually be half that number because the other half are replacing existing beds. The question I asked last week in the Seanad was about what the people of Limerick are supposed to do in the meantime. It completely undermines confidence in our public health system. This is the type of factor that drives people towards the private health market.

It is a good time to revisit this topic to see what we should be doing to drive the process of Sláintecare forward and to acknowledge that health insurance does not deliver in many respects. For example, it does not cover primary care. One of the new problems we have now is that people are struggling to access GPs, never mind pay the costs to see them. We also know that unless someone has a Rolls-Royce package, private health insurance often does not work in reality. We see queue skipping and the purchasing of private healthcare in public hospitals. These are things we just need to move away from. As a party committed to a national health service, Sinn Féin is very clear that its priority will be to remove private healthcare from our hospitals and to do so far more quickly than it is being done at present.

I will address the issue Senator Conway raised because I have also been approached by organisations representing overseas students. We were expecting an amendment to this Bill.I know it is not now coming forward, but this is an issue that was raised with me more than a year ago. I want to pay credit to Senator Hoey, and Senator Malcolm Byrne has also been working on this issue. We need to look after these students. It is grossly unfair they are excluded from this scheme at present. I ask the Minister of State for a response on what actions are being planned and what will happen for those people.

The one issue I have with the Bill is in section 4, where we see an increase in the "reasonable cost" from 4.4% to 6%. I want to understand why that is. I would have thought we should not be increasing those costs at this point in time. If the Minister of State had a comment on that, it would be very helpful.