The Taoiseach will recall that I asked a series of questions about the legislative commitment in the programme for Government about the health service and universal health insurance, UHI. I did so in the light of comments made by the new Minister for Health, Deputy Varadkar, about delaying or deferring the abolition of the Health Service Executive and the officials saying the construct was simply unworkable. I asked about the legislative commitment to the hospital insurance fund, and when the legislative basis for UHI would be enacted. The programme for Government says it will be enacted in the first term and, "The HSE’s function of purchasing care for uninsured patients will be given to a Hospital Care Purchase Agency” and so on.

Where is the Deputy going?

Promised legislation. It goes on, "The Patient Safety Authority will introduce a national licensing system for hospitals, and will oversee the transition of hospitals from the HSE to independent local control".

The reply I received is a masterpiece of penmanship from a system that wants to change track but is hoping people will not spot that. It states that there will be no patient safety authority. For three and a half years I have been asking the Taoiseach about the patient safety authority on the Order of Business and he has assured me that it is coming, it is on the way and so on. The reply states that the Department of Health is not developing any legislative proposals that would establish a patient safety authority on a statutory basis. The HSE intends to establish a patient advocacy agency initially within its own structures.

We will not go into all of this on the Order of Business.

This is important.

I know it is important but not on the Order of Business. That is the big difference.

It is central to the Order of Business because it concerns the programme for Government and we can ask about legislation. The fundamental question is who wrote this because not a bit of it will be implemented. The most honest thing the Taoiseach could do is to at least rewrite and admit that. It states that the Future Health document, which the Government published, referred specifically to the “reform – learn – reform” approach. I love that. It "will allow us to make changes to the proposed approach while simultaneously making progress towards the final structures and delivering tangible improvements as we go". Can someone explain that to me? Is that what the Minister for Health, Deputy Varadkar, said when he was changing the tack set by the former Minister, Deputy James Reilly, that he would take the “reform – learn – reform” approach?

We are not going through the whole programme for Government on the Order of Business.

There is more legislation mentioned here. It states what the Minister and the Department are now doing. That is significant, what they are now doing.

That is all very interesting but perhaps the Deputy would find some other way of relating it.

Will the Taoiseach explain where stands the programme for Government?

There are Members waving at me all over the Chamber wanting to raise issues and I have to listen to a repeat of-----

This is the programme for Government.

We can all read it if we get a copy of it.

I have read it.

Not on the Order of Business.

It is an Order of Business question. It is central to the legislative programme.

The Deputy should respect his colleagues.

There are another 27 minutes to go on the Order of Business, with the greatest of respect, so there is plenty of time.

The Deputy has just taken up three minutes of it.

This is a very serious matter because the health service is crumbling. Where stands all of this, two and a half to three pages of legislative commitments made by the Government? It is a fairy tale. It was an untruth peddled to the people before the last general election and has been peddled for the past three and a half years.

What legislation exactly is the Deputy inquiring about?

It is on the first three pages of the letter.

This letter illustrates that.

I am not dealing with letters on the Order of Business.

It is done in the nicest way possible from the Government’s perspective, whoever put it together. The Taoiseach should please not tell us he is going to do it all in the next five years, or the five years after that because that is the new trick. Whatever the Government could not do in this four years it says it will do in the next five years. It was a con job. The Taoiseach repeated the soundbites “money follows the patient” and the “Dutch model”. Does he remember the Dutch model? The Dutch model has disappeared. She is nowhere to be found in the health system. It is an appalling con job on the Irish people.

I thank the Deputy for his-----

Analysis.

-----response. He asked a load of questions. I answered them in my letter.

The Taoiseach did not answer them.

The Deputy did not mention the section of the letter in which I was happy to report that good progress is being made with many aspects of the reform programme, including the introduction of new governance and management structures in the HSE following the enactment of the Health Service Executive (Governance) Act 2013.

There is no independent board.

The Deputy did not have the courage to stay where she was.

The Minister of State is not even in the Cabinet.

I mentioned that chairpersons are in place for six of the hospital groups, with the role being filled on an interim basis in one case. The legislation for the disestablishment of the HSE has passed through the Oireachtas and will take effect from 1 January 2015. The health care pricing office has been established in the HSE. The implementation of the "money follows the patient" approach has commenced. The Deputy did not refer to any of that.

I ask the Taoiseach to read the next paragraph.

The Government has also decided that the second phase of the roll-out of universal GP care will involve people aged 70 years and over.

He has skipped over it. He should have read the next paragraph.

The Government has approved the drafting of a Bill to provide a GP service without fees to all people aged 70 years and over. The drafting of the legislation in question has commenced.

Their medical cards are being taken away.

Medical cards have been taken from the over-70s.

Discussions on the subject are ongoing between the Department and the Office of the Attorney General. The expectation is that the health (general practitioner service) (No. 2) Bill will be published shortly. The Deputy chose not to mention that. Obviously, he is aware that the Government published a White Paper on universal health insurance in April of this year. The Department initiated a consultation process on that White Paper. An independent thematic analysis on the submissions has been awarded. The Minister will receive that analysis back shortly.

Absolutely.

The Department has also initiated a major costings exercise.

It is winding down the clock to the next general election.

It will estimate the cost of universal health insurance for households.

Four years on and there are no costings.

The Exchequer and the Department are working with the ESRI and the Health Insurance Authority. Does the Deputy not think it is appropriate that we should be able to set out the overall costing of the introduction of universal health insurance?

I would have thought the Taoiseach and his colleagues would have had that information before they put this proposal to the people.

I might add that it is not based on the Dutch model.

It should have been done at the beginning rather than at the end.

Sorry, Deputy, would you please respect the Chair?

The Dutch model has faded.

Has it? Hallelujah.

That is a newsflash.

This is an Irish version of universal health insurance for Irish circumstances.

I remember the pre-election debates in which the Taoiseach ploughed on about the Dutch model for all she was worth.

The Dutch model of universal health insurance was never going to be the one that would be suitable for Irish circumstances.

She has faded into oblivion now.

A bit like the Deputy.

We have the Danish model now.

Deputy Martin does not want to acknowledge that a great deal of work is taking place.

Perhaps we will have the Soviet model next.

He asked the questions and I responded to him. It is okay that he is not happy with some of the responses.

The Minister, Deputy Varadkar, has said he is developing structures to replace the HSE.

A great deal of work has been done.

That is being done after it has been abolished.

If the Deputy is not happy with the responses, I suggest he write back to the Taoiseach.

New structures to replace the HSE have yet to be developed even though the HSE has been abolished. One could not make this up.

The programme for Government promised that universal health insurance would "provide guaranteed access to care for all in public and private hospitals". My presumption is that this includes the right to midwifery services. I want the Taoiseach to give us clarity on this if he can. I have just learned that 25 pregnant women have been told that no midwifery services will be available to them because the HSE has revoked midwives' licences. These women have not been informed of alternative arrangements. Does the commitment in the programme for Government include the right of pregnant women to these essential services?

The section of the same programme for Government dealing with passports, citizenship, immigration and asylum promised to "introduce comprehensive reforms of the immigration, residency and asylum systems" and to set out the "rights and obligations in a transparent way". When will the Government fulfil this commitment? There is anything but transparency for these people. I note that an tUachtarán, Michael D. Higgins, was stopped from visiting an asylum accommodation centre recently. Will some of the Government's time be set aside for the Minister to come to the House to explain why the President was barred from visiting asylum accommodation? I have visited the Mosney centre. Some of the people have been there for more than a decade. Will the Government honour its promise to give certainty to these people, to end direct provision and to close the centres associated with it? We should be given an opportunity to listen to an explanation of why the Head of this State was denied the right to visit one of these accommodation centres.

I want to make it clear what is in order on the Order of Business. Promised legislation is in order. To be clear, the programme for Government is not a catch-all for raising matters on the Order of Business. It is in order to raise items covered in the programme for Government only if they have been elevated to the status of promised business such as legislation. In other words, we cannot have a debate every day on something in the programme for Government. This is not suitable for the Order of Business.

When did that come in?

If the Whips want to come up with some other arrangement for how we can deal with these issues, by all means I will obey those new rules. I have to apply the rules as they are. I ask for the co-operation of Deputies in doing so. I call the Taoiseach to reply.