I call Deputy Adams.

Go raibh maith agat, a Cheann Comhairle. Cuirim fáilte romhat. Tá an Punch and Judy ann arís. Cuirim failte roimh an Taoiseach fosta. Nuair a d'imigh an Dáil ar sos, bhí géarchéim ann. Táimid ar ais arís agus tá géarchéim níos mó ann. Tá sé sin an-soiléir maidir leis an Roinn Sláinte.

The Government's commitments in reforming the health service lie in tatters. In his very first act as Minister for Health, Teachta Leo Varadkar has shelved the Government's so-called big idea of compulsory private health insurance. B'fhéidir go raibh sé ag éisteacht le Sinn Féin.

The Minister also stated plans to replace the HSE and other reforms were "over-ambitious from the start." The Minister has torn up the Government's timetable for free GP care which the Taoiseach will recall was one of the cornerstones of the famous five-point plan. Last week the Taoiseach publicly chastised the Minister. The Taoiseach defended his predecessor, Deputy James Reilly, in every controversy and debacle in which he became involved and made it clear that he was implementing Government policy and Cabinet decisions. The Minister, Deputy Leo Varadkar, has ditched the Government's policy.

Where is the Minister?

Sinn Féin argues that the Minister should build a universal health service based on need, not wealth, and that it should be paid for by direct taxation.

Will Members, please, remain quiet?

It is impossible to know what is the Government's health policy. In such circumstances, will the Taoiseach spell out for the House and, more importantly, patients and their families the nature of that policy?

I will defend every Minister-----

That is why Deputy Alan Shatter finds himself on the backbenches.

-----in following through on implementation of Government policy.

Until the Taoiseach sees fit to sack them. Those opposite should be worried when they hear the Taoiseach say that.

I do not like speculative comments from anybody, particularly in the context of collective Government responsibility and the revelation of budgetary details on which decisions have not yet been made. Everybody understands this.

In so far as the Government is concerned, I expect that Deputy Leo Varadkar will prove to be an outstanding Minister for Health-----

And that he will keep his mouth shut.

Put a muzzle on him.

Give him €500 million.

-----and that he will complete the process of delivering on some very challenging commitments. In that regard, what he does will follow on the many difficult decisions made by his predecessor, Deputy James Reilly.

A sum of €500 million will sort him out.

Perhaps the comedians might stay quiet for a little while.

The biggest comedian is on the other side of the House.

The former Minister for Health did not leave behind-----

The Taoiseach is the biggest comedian around here.

I ask Members not to make a show of the House on its first day back after the recess.

The lads opposite appear to be a little frisky at this early stage.

The Government is fully committed to the introduction of universal health insurance in the interests of ending a two-tier system that is discriminatory and inequitable and that has not worked. Even when €15 billion was being spent on that system, it did not deliver the goods. Universal health insurance will be introduced during the second term of the Government. However, a number of steps must be taken prior to that happening. These involve the strengthening of primary care services - primary care centres are being rolled out at an average of one a month - continuing the work of the special delivery unit in tackling waiting times and waiting lists, the introduction of the money-follows-the-patient model in order that people will have greater control over the services of which they wish to avail and the introduction of hospital groups which in due course will be obliged to make fundamentally important decisions on health services. When these building blocks are put in place, the introduction of universal health insurance will follow. In essence, universal health insurance will mean that every patient will become central to the system. As a result, people will be tended to, as a priority, on the basis of their medical needs as opposed to what they have in their pockets. As the Deputy is aware, not every patient can afford to go to other places for treatment.

Maith thú, Taoiseach. In the first instance, I cast no aspersions on the Minister for Health. As is the case with all of his ministerial colleagues, I wish him well. The Taoiseach has stated that all of the steps to which he refers will be taken during the Government's second term. Did I hear him correctly?

The Deputy should ask a supplementary question.

I stated universal health insurance would be introduced during the Government's second term.

We are not having chats across the Chamber. The Deputy should put a supplementary question. He has one minute in which to do so. That is it.

Before the Government is given a second term, a very important element will enter the equation, namely, the people. They will have their say on whether the Government remains in power for a second term. The Taoiseach avoided the opportunity to set any real policy direction or to outline a programme of reform. He did not, for example, indicate how the election slogans or commitments which have, in fact, been torn up would be realised. Even as the autumn of its term of office approaches, there is an opportunity for the Government to abandon this unworkable policy and introduce a new approach based on genuine reform and equality and which prioritises the delivery of front-line health services and to end privatisation and establish a truly universal health care system with access for all on the basis of need rather than wealth.

This matter relates to citizens, patients, children who face huge life challenges and some of whom have terminal illnesses and the elderly. All of us have been sick at some time or other. The people to whom I refer look to the Government to solve the problems and provide the services that they require. In a society which refers to itself as a republic, a public health service that can provide people with the comfort they need is a very basic entitlement. Instead of making general remarks-----

The Deputy is way over time.

-----will the Taoiseach set out in the short time available to him the Government's current health policy, particularly in view of the fact that the Minister for Health has torn up the old one?

The Deputy has pointed out exactly what the Government intends to do in putting in place a universal health insurance system to which the needs of the patient will be central. He has echoed my words to the effect that the patient is central and that he or she will be treated on the basis of his or her medical needs as distinct from his or her income. In order to reach that point, certain foundations and building blocks must be put in place. I have already referred to them. They are: the money-follows-the-patient model; the special delivery unit's work to tackle waiting times; primary care services; and hospital groups. The money-follows-the-patient unit has been established; negotiations with GPs are under way and hospital groups have been established in a number of instances. Legislation is being processed to facilitate this. These are important steps on the way to creating a universal health insurance system.

I am glad that the Deputy shares the Government's view. People and patients are central to all of this. The people gave us a mandate to fix the public finances and get the country working. All the big indicators are pointing in the right direction and people understand this. We must make the benefits filter down to every house throughout the country in order that people can understand what has been achieved. In the context of the health system, the patient is central. That is the focal point with regard to universal health insurance. In order to achieve this during the Government's second term, these essential building blocks must be put in place. I know that the Deputy shares my view of that concept.

Dream on.