Before I start, may I compliment the Minister, Deputy Noonan, on the manner in which he dealt with his recent surgery and to wish him every best wish in the time ahead? It has been a good week for Limerick, what with the hurling and the Minister's own good performance-----

Up Tipp.

-----and so we await a good summer and well done to the Minister in this regard.

I put into the Minister that Ireland is in the midst of a crisis in the health insurance market. It is undoubtedly experiencing a downward death spiral and an approximate average of 4,000 customers left the market each month in the year up to March 2014. Moreover, 21,000 people have left since the beginning of this year alone, that is, approximately 1,600 per week have quit during the first three months of this year. There has been a haemorrhaging of young and healthy customers from the market, which threatens the very sustainability of the health insurance market into the future, leading to much higher premiums for those who remain in the health insurance market, as well as creating huge pressures for the public health system as Members are aware and as is being experienced.

In response to this, Government policy is incoherent. Insured patients are now subject to dramatically increased charges for public hospital beds - up to approximately €852 per night - which constitutes a dramatic increase. If one adds to this the significant curtailment of tax relief that was announced in this year's budget, overall one gets a Government charge of approximately €300 million. The Government has dipped into the pockets of private health insured people to the tune of approximately €300 million in recent times. All of this has had a dramatic impact and has accelerated further the exodus from the health insurance market itself. Meanwhile, the Minister, Deputy Reilly, peddles the mandatory universal health model, which is vague and uncosted. Incidentally, I note the Taoiseach failed to voice confidence in the Minister for Health yesterday, having been asked to so do.

How could he?

Does the Government accept there is a crisis in the health insurance market? Has it proposals to help to resolve the crisis?

The backbenchers want to get rid of the Whip as well.

Hold on a second, you are not Minister yet.

They want to see the back of him too. He is on the hit list.

There will be a shake-up over there, a Cheann Comhairle.

First, I thank Deputy Martin for his good wishes, which I very much appreciate.

From the point of view of the Minister for Health, his clear objective is to reform the current health system and to deliver a single-tier health service in which access to health care is based on need and not on the ability to pay. The Government is committed to the ongoing sustainability of the health insurance market as part of the transition to a market-based universal health insurance system. At the end of March 2014, some 2.3031 million people were insured with inpatient health insurance plans. While the number of people covered has fallen from a peak in 2008, Ireland continues to retain a high level of population holding voluntary private health insurance at 44.2%. The Minister for Health desires the best possible environment within which more people, particularly young people, will wish to obtain and retain private health insurance cover that is affordable, competitive and meets consumer needs.

He intends to introduce shortly a series of measures to help to support the sustainability and competitiveness of the private health insurance market. This includes lifetime community rating to encourage people to join health insurance schemes at a young age and to retain their private health insurance cover. In addition, the Minister will announce shortly an initiative on mandatory discounts for young adults. The Government is committed to keeping affordable health insurance for as many people as possible. To this end, the Minister has made clear to the health insurers his belief that significant savings from within the industry can still be made, the effect of which can be to minimise the need for increases in premiums. The recently-published McLoughlin interim report on health insurance costs made recommendations in a number of different areas, including the important role of clinical audit in identifying unnecessary claims. Moreover, the need to address the age structure of the private health insurance market is also important. As I already mentioned, the Minister, Deputy Reilly, will provide further details on his plans in this regard shortly.

I put it to the Minister that the market is no longer affordable for many people, particularly younger people, who are leaving the system in their droves. The situation was already critical enough but the Government added to the crisis by the measures it took in the budget. I do not simply refer to the restriction of tax relief but also to the increase in the cost and price of a public bed in a public hospital. This concerns people who were also paying their taxes but the bottom line is there is no confidence that the Minister has the capacity to sort this out. There is no confidence among Government backbenchers in the Minister or in his capacity to resolve this crisis. Indeed, members of the Labour Party have been saying openly for quite some time, over the past year and a half, that they did not think he was up to it. Although they did nothing about it-----

As usual.

-----they said that and let everyone know about it.

A question, please.

Apparently, the five-a-side group is back and it is playing its game of five-a-side very actively at present.

Again.

They came out of their coma.

However, most critical of all, the Taoiseach did not say he had confidence in the Minister. He refused to say he had confidence or no confidence in him-----

A question, please.

-----which is kind of ominous. Will the Minister be around to implement these changes?

The Deputy knows he will not.

Moreover, I do not believe these changes will be adequate to deal with this crisis because the fundamental objectives of Government health policy are not meeting. On the one hand, the Government seeks universal mandatory health insurance but, on the other, it is implementing policies that are driving people out of the market, such is the incoherence of the policy approach. Very few people on the Government side appear to have confidence in the Minister's capacity to resolve this. I do not know why the Government should believe that anybody else outside of Government or the realm of Government backbenchers should have some confidence.

First, the economic policies pursued by the Government in which Deputy Martin participated from 2007 until 2011-----

Change the record. It is broken.

-----resulted in the loss of hundreds of thousands of jobs. When hundreds of thousands of people lose their jobs, they look at their expenditure patterns and one thing they inevitably give up is voluntary health insurance. The unemployed, as a result of the crisis Deputy Martin's Government caused, were the people who gave up health insurance. This happened in two ways, namely, through individuals making voluntary decisions and through people no longer at work losing out in the group schemes for health insurance that they enjoyed at work.

These are working people who have given up.

There are 70,000 at work in Canada.

There is nothing mysterious about this. In times of recession, when people lose their jobs, they cannot afford what they could afford when at work. Consequently, rather than trying to blame the current Minister, Deputy Martin should take some responsibility himself for the devastation he visited on hundreds of thousands of families in Ireland.

Change the record.

The Government was warned about this in January.

As for the second issue on the ability of the Minister for Health to deal with the issue, I have outlined what he intends to do and, by any standards, what I have outlined is a serious programme of reform that addresses the issues. More than 44% of people in this country still have voluntary health insurance for which they pay.

If one looks at the numbers over the years, this is quite high. Looking at the numbers back to the late 1990s, for example, it is below the peak of 2008 but practically everything in this country is below the artificial peak of 2008 when the boom and bust economy finally burst.

Including the Fine Gael vote.

He is a walking disaster.

Could you just stay quiet for a few minutes, please?

It was lucky he was around the night you needed him.