At the heart of the Government's policy in the programme for Government are two key issues with regard to health, the introduction of free GP care for all by end of the lifetime of the Government and the establishment of universal health insurance after the next election. By any stretch of the imagination and to say the very least and be polite, progress to date has been minimal. The funding model that is being proposed by the Minister for Health is a form of universal health insurance and, at the same time, two key Ministers in government, the Minister for Finance and the Minister for Public Expenditure and Reform, are cynically undermining that proposal. Before the previous general election, the Minister for Health, Deputy Reilly, said no one would pay any more than they are paying already for health insurance. Clearly, that has not happened, with massive increases in private health insurance costs, year in, year out, in the interim, forcing families to abandon it at a rate of up to 6,500 people a month.

We await the publication of the White Paper on universal health insurance. Last Monday the Minister for Finance was quite robust in undermining the principle of universal health insurance, saying it would expose the State and families to huge costs. This is coupled with the leaks last week from the office of the Minister for Public Expenditure and Reform, Deputy Howlin, that families will have to pay up to €1,600 for the basic health cover that is being proposed by the Minister, Deputy Reilly.

First, does the Tánaiste agree that the panacea announced by the Minister, Deputy Reilly, three years ago, where nobody would pay any more than they are already paying, is now a fallacy in the sense that people are already paying substantial sums over and above that? Second, when will the White Paper be published in order that we can have an informed debate on this issue? We are depending on scraps and leaks from Government and from individual Ministers trying to undermine what is a central core principle of this Government in regard to the delivery of universal health insurance. Does the Tánaiste agree the White Paper should be published immediately and that we should have an informed debate on it? Clearly, the document we published last year would indicate it will not be utopia if we introduce universal health insurance, as proposed by the Minister, Deputy Reilly, because, simply put, it will cost an awful lot more than people are paying in private health insurance at present. Is the Labour Party happy with giving over health insurance to private companies-----

They are never happy.

-----which will decide whether health is rationed and what sort of basic policies will be put in place with regard to cover for ordinary families in this country?

The Government has agreed to the introduction of a policy of universal health insurance. That has been the policy of my party for more than a decade. It is something that is coming after a period of Fianna Fáil-led Government when it showed no interest in reforming the unfair two-tier health system we have had for a long time in this country. It still does not, of course, which is why it has opposed the Government's proposals to give a break to families with a medical card for their children.

The Government believes people should be treated based on medical need, not on the amount of money they have in their pockets, so people who get sick know they can get treated in good time. We also want to change the incentives to the health system in order that the majority of people get treated in their communities and do not end up unnecessarily in accident and emergency or in a hospital bed. That makes sense when it comes to keeping people healthy and spending taxpayers' money in a way that is most effective. That is why, for example, the Government has put an emphasis on putting in place the building blocks for a universal health insurance system. It is why we decided to lower the cost of accessing primary care for people, starting with the introduction of free GP visits for children aged five and under. It is also why we are building up the primary care system.

The introduction of universal health insurance is a major reform project. It is not going to happen overnight and it is important we get it right. We are not rushing it. There is a lot of preparatory work that has to be done and the White Paper is part of that. It will be the basis for the consultation, including what should be included in the guaranteed basket of services. Other preparatory work is also ongoing, such as the introduction of the money follows the patient concept across the public hospital system and free GP visits for those aged five and under. Regarding cost, as I said, we must proceed cautiously. We want a more efficient health system that delivers better value for taxpayers and we also need to keep health insurance affordable.

We are at an early stage in this. The Department of Public Expenditure and Reform and the Department of Finance, as one would expect them to do, are doing their job, which is to probe the costings and to maintain an oversight of policy in terms of its cost implications at an early stage. We want, over time, to reform the health service in order that it treats people as early and efficiently as possible. To do that, we want to keep health costs affordable for families and for the taxpayer. The alternative, of course, is the Fianna Fáil alternative, which is to do nothing and to allow a drift. That is not acceptable to us. The White Paper is being prepared. It will be published in the not too distant future and it will provide an opportunity then for all of us to have an input into the discussion on how universal health insurance is progressed.

The Labour Party may have been proposing a universal health insurance model but it was on a funding system of social insurance as opposed to private insurance companies funding the health model. There is quite a large difference between the two.

At the outset, the Tánaiste said the Government wants to introduce a policy that would give access to people based on their medical need as opposed to their ability to pay. In the last couple of months, it has decided to announce free GP care for those aged under six but, at the same time, it is funding that particular initiative by taking medical cards off the sickest in our society. The idea that the Tánaiste would come into the House and say the Government wants to ensure people will access treatment based on their need simply is not credible when one looks at what the Government has done in regard to discretionary medical cards, week in, week out, withdrawing them from the sickest and most vulnerable in society.

It is a stunt.

Does the Tánaiste accept that, after three years, the Minister for Health has now been completely isolated in government? The Minister for Finance, by his policies, consistently undermines the basic principle of universal health insurance, which is a dynamic private health insurance market where people can afford insurance. Every policy the Minister for Finance has introduced in this House has undermined that basic principle, including the capping of tax relief on insurance premiums and now a further threat to remove tax relief altogether from hard-pressed families.

The Government is talking about a universal health insurance model whereby health insurance companies will be the ones who will fund the system through people taking out health insurance. By any stretch of the imagination and looking at it coldly and clinically, the Government is undermining that basic principle, day in, day out, by the policies it has pursued for the past three years. When will the White Paper be published and will it have detail and costings? The public want to know whether the Minister, Deputy Howlin, is scaremongering or telling the truth with regard to a cost of €1,600 per person for universal health insurance.

Let me correct a number of issues of fact. First, the Labour Party position on universal health insurance, which was initially published in 2001, provided for and proposed that there should be a number of health insurers which would be part of universal health insurance, one of which would be a public service provider. That was and is the position of the Labour Party in regard to universal health insurance.

It is not the position of the Government.

Second, with regard to medical cards, Deputy Kelleher is also wrong.

The Government is providing 500,000 more medical cards to people than Fianna Fáil did when it was in Government.

Allow the Tánaiste to continue.

In fact, it is more. A total of 590,000-----

We are not in the business of shouting down people. Will Deputies allow the Tánaiste to reply to Deputy Kelleher?

There are now 590,000 more medical cards in the system than there were when Fianna Fáil was in government. That is a fact. I cannot understand why Fianna Fáil continues to oppose the Government's plan to provide free GP care to children under six. It is something that will take pressure off families and it is also an essential building block for the introduction of a universal health insurance system. As I said, the introduction of universal health insurance cannot be done overnight.

It was promised it would be done overnight.

It was not. Deputy Kelleher should at least inform himself and do a little bit of research before he comes in here. It was not promised-----

On a point of information, the White Paper was to be published 18 months after the Government was formed, and the Government was formed three years ago.

It was never intended that it would be introduced overnight. It is something that requires careful consideration, which is why there will be a White Paper. The White Paper will be published when it is ready. I do not expect that this will be very far into the future. Deputy Kelleher will then have an opportunity to condemn and criticise it, as inevitably he will do.