Niall Ó Donnghaile (Sinn Fein) | Oireachtas source

That is a different story. As other colleagues have noted, the Minister of State is very welcome to the House. I also appreciate her regular engagement with this Chamber. Before coming to speak to the Bill before us tonight, I am sure she and other colleagues will join me in sending our solidarity and support to the nurses in the North of Ireland and in Britain, who are on strike at the moment. They will go out onto the picket again tomorrow. It is an absolute disgrace that they have to do that, not least in sub-zero temperatures. I call on the British Government to bring forward a deal that meets the needs of those workers, who are out for fair pay and better working conditions. In particular, I note the sterling work of Pat Cullen, the secretary general of the Royal College of Nursing, RCN. She is a Tyrone woman, but she has lived in south Belfast for many years and she has provided first-class leadership to the nurses there. I thought it was important to make reference to that.

I have spoken on this legislation previously. I must reflect on my own experience as this State moves ever closer to a universal healthcare system. I am very conscious that I have had the privilege to grow up with a universal healthcare system, free at the point of delivery, in the North. It is deeply regrettable and hugely regressive that it seems the British Government is moving further away from that all of the time by hollowing out the NHS and moving to a privatisation model. We are seeing the consequences of some of that in the strike action by the nurses, but sin scéal eile.

I want to set my comments on the Health Insurance (Amendment) Bill in the context of how people in need of the health service or those who work in it currently experience it at the point of delivery. I am stating the obvious when I say that our health is our wealth. Is fearr an tsláinte ná na táinte. From the cradle to the grave we all, at some time on the spectrum of life, will use the health service. I am also stating the obvious when I say that the health service of this State is not in a particularly healthy state. Currently, there are 1.3 million people on some form of health waiting list; 897,000 people on hospital waiting lists - 200,000 waiting for more than a year, which I acknowledge is down since last year, but nowhere near where it needs to be. Some 200,000 people are waiting on a diagnostic scan; 97,000 children are on hospital waiting lists; 100,000 children are on community waiting lists; and 18,000 on children disability network teams, CDNT, waiting lists. The Minister's approach to waiting lists is failing.

It is no wonder that half of the population hold onto their private health insurance. However, we must recognise the shortcomings of private health insurance.Sinn Féin tabled an amendment previously when the Government saw fit to increase the profit allowed for insurers from 4.4% to 6% with no improvement to those services. We sought to reverse this increase and to undo it at a time of rising costs of living for families across society. We are all caught in that cost-of-living crisis, whether it is rising energy costs, insurance costs, food costs or all the other costs that people face.

All of that said, as the Minister of State will know from contributions in the other House, Sinn Féin will support this Bill as we always have. We recognise the reliance of many people on health insurance. It is an annual Bill that renews the risk equalisation mechanism that supports the community-rated health insurance market. The Bill revises the stamp duty levy on policies and the risk equalisation credits payable to insurers for 2023. It is a self-funded system. Risk equalisation ensures costs are constant across the lifespan of the individual. It seeks to ensure, where possible, that age, gender and health status do not influence the cost of insurance product.

In supporting this Bill, I want to make our criticism of the current insurance market and the two-tier healthcare system in this State clear. The two major areas in which little progress have been made and that are relevant to this Bill are, first, removing healthcare from public hospitals and, second, expanding universal GP access and free GP care. The lack of action is driving much of the private sector activity in healthcare, which is embedded in our public hospitals. We need, once and for all, as other colleagues acknowledged, not just to agree but to deliver on the commitment to disentangle private healthcare from public hospitals. In addition, the Government needs: multi-annual capital funding to enable quicker delivery of hospital expansions; a strategic workforce plan to expand training and the number of workers to deliver universal GP care or expand primary and community care to reduce the burden on acute hospitals; to address the shortage of home support assistants or transitional step-down beds; and a plan to remove out-of-pocket charges and make all health and social care free at the point of delivery.

While Sinn Féin supports this Bill, we do so because it is technical legislation. We do not support a two-tier health service. That is the crux of the issue. When it comes to removing private healthcare, to free GP care, investing in public health care, and reducing people's need for private health insurance, Government policy is defined by a failure to plan. This Government is without a health service plan and, unfortunately, it shows.