Billy Kelleher (Cork North Central, Fianna Fail)
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Question 629: To ask the Minister for Health the basis for his decision not to regulate the VHI until the end of 2013; the reason it is not possible to do so at a much earlier date; if Ireland will face any sanctions from the European Commission for its failure to do so; and if he will make a statement on the matter. [5409/12]

James Reilly (Dublin North, Fine Gael)
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The Government has decided, on foot of my recommendations, that the VHI should make an application for authorisation by the Central Bank, subject to further Government decisions to be made relating to capitalisation, once the level of its capital shortfall is clarified. The VHI has been working for some time in preparation for this.

As the Deputy will be aware, the European Commission took a case against the State regarding the VHI's derogation from the EU Non-Life Directives which had exempted it from the requirement to be authorised by the Central Bank. The Court of Justice of the European Union ruled against the State on 29 September last. VHI's regulatory status is bound up in a range of issues relating to the private health insurance market which I have been addressing over the past number of months. In order to be considered for authorisation by the Central Bank, VHI will need to present a sustainable business plan. Due to the current imbalance of the community rated private health insurance market, where the vast majority of claims are paid out by the VHI, the market requires an effective scheme of risk equalisation to address that imbalance. Work is ongoing in my Department to legislate for such an effective, robust and permanent scheme in the coming months, following the Government's recent agreement to my proposals in that regard. The new scheme will need to be cleared at EU level in relation to State Aid rules. In the meantime, on foot of recommendations of the Health Insurance Authority following its analysis of the market, the level of age-related tax credits payable in 2012 in respect of customers over the age of 60 has been significantly increased.

Following the Court of Justice judgment, the Government made decisions on how best to address the Court's findings. The Governments plans and a realistic timetable were outlined to the European Commission on 9 December last. Resolution of the issues will involve a number of steps. The timescale for some of these steps is outside of the State's control and will depend on the time it takes for decisions to be made by the European Commission itself regarding State Aid issues, as well as by the Central Bank.

Once it is clear, following the analysis of the Central Bank and the European Commission, what additional capital the VHI would require in order to secure authorisation and to satisfy any State Aid implications which may arise, the Government will consider the matter and make further decisions in that regard.

It is clear that all of these actions must be undertaken in an orderly and efficient manner but that this will take time. The timescale outlined to the European Commission is intended to allow for these issues to be addressed in such an orderly and efficient way. Officials from my Department remain in contact with the European Commission on an ongoing basis and will work to satisfy the Commission's concerns and to advance the resolution of the regulatory status of the VHI as quickly as possible.

Billy Kelleher (Cork North Central, Fianna Fail)
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Question 630: To ask the Minister for Health if he has any concerns that private health insurance policyholders, particularly vulnerable subscribers, may be exposed by the fact that the consumer protection code does not apply to the VHI; the steps he will take to remedy this situation; if he supports having the code apply to the VHI in advance of full regulation of the VHI; and if he will make a statement on the matter. [5410/12]

James Reilly (Dublin North, Fine Gael)
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The VHI has voluntarily committed itself to implementing the requirements of the Consumer Protection Code over the past number of years. Subscribers can be assured that VHI is committed to satisfying the Central Bank of its ongoing compliance with the Consumer Protection Code. This forms part of the steps the VHI is taking in the context of the application which it is currently preparing for authorisation by the Central Bank.

In addition to the Code, the VHI is working to satisfy a range of other qualitative issues which the Central Bank requires from any authorised entity.

Billy Kelleher (Cork North Central, Fianna Fail)
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Question 631: To ask the Minister for Health if he will provide an update on the health insurance consultative forum which he announced in late December 2011; if he will outline the membership of this forum; the number of meetings the forum has held to date; the terms of reference and work programme of this forum; when this forum will complete its work and report to him; if its findings will be published; and if he will make a statement on the matter. [5411/12]

James Reilly (Dublin North, Fine Gael)
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I recently announced the agreement reached with the country's main health insurers to establish a Health Insurance Consultative Forum to tackle issues of mutual concern. The purpose of this Forum is twofold.

Firstly, the Forum will provide the opportunity for participating parties to examine how costs in the health insurance sector can be reduced and how savings can be achieved in terms of services provided by both public and private hospitals. Secondly, the Forum will also facilitate participating parties to consider certain issues related to the implementation of Universal Health Insurance (UHI). The future delivery of health services under UHI will require competing insurance companies driving efficient, cost effective delivery of high quality health care. The Forum will allow the insurance companies consult with my Department on many significant changes on the road to the full implementation of UHI.

Details on the membership and terms of reference for the Forum are currently being considered and I will announce these in due course.

Billy Kelleher (Cork North Central, Fianna Fail)
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Question 632: To ask the Minister for Health if he will provide an update on the working group on universal health insurance which he announced in September 2011; the membership of this group; the number of times this group has met to date; when this group will conclude its work; when it will report to him; if its findings will be published; and if he will make a statement on the matter. [5412/12]

James Reilly (Dublin North, Fine Gael)
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The Government is committed to fundamental reform of the health system. This will see the delivery of a single-tier health service, supported by universal health insurance, which will ensure equal access to care based on need, not income. The universal health insurance system will be based on the principle of social solidarity. Every citizen will have a choice of insurer and will have equal access to a comprehensive range of curative services.

Key features of the reform programme which will underpin the introduction of universal health insurance include:

the strengthening of primary care services to deliver universal primary care with the removal of cost as a barrier to access for patients,

the work of the Special Delivery Unit in tackling waiting times,

the introduction of a more transparent and efficient "Money Follows the Patient" funding mechanism for hospitals, and

the introduction of a purchaser / provider split, whereby hospitals will be established as independent, not for profit trusts.

In order to assist in developing detailed and costed implementation proposals for universal health insurance and to help drive the implementation of various elements of the reform programme, the Government has approved the establishment of, and the terms of reference for, an Implementation Group on Universal Health Insurance. I am currently finalising details of the Implementation Group, including its composition and timeframe for reporting, and I will announce these very shortly.

Billy Kelleher (Cork North Central, Fianna Fail)
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Question 633: To ask the Minister for Health when he intends to introduce revised minimum benefits regulations; and if he will make a statement on the matter. [5413/12]

James Reilly (Dublin North, Fine Gael)
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Minimum benefit is one of the key principles on which the Irish private health insurance regulatory system is based. Minimum Benefit Regulations, made under the Health Insurance Acts, require insurers to offer a minimum benefit to every insured person. The key purpose of the Regulations is to ensure the continued availability of the type of broad hospital cover traditionally held as a minimum by the insured population and to ensure that individuals do not significantly under-insure. Minimum Benefit Regulations were introduced in 1996, under Section 10 of the Health Insurance Act, 1994 and cover in-patient, out-patient and day-patient services provided by publicly funded hospitals, private hospitals, registered nursing home and hospital consultants.

As the Regulations were drafted in 1996, they require updating in terms of the monetary amounts and some medical and surgical practices specified therein. The consumer price index, health cost inflation for hospital services and hospital charges have all increased significantly from that time. In addition, there have been significant changes in some medical and surgical practices in the last number of years.

Consequently, the Minimum Benefit Regulations need to be reviewed in order to reflect changes in medical practice as well as changes to the costs of health services. It is intended that the current regulations will be examined over the coming months as part of the overall strategy to address issues in the private health insurance market, leading in to the introduction of Universal Health Insurance.