Universal health insurance
Martin criticised the Government for lacking costings for its promised universal health insurance scheme. The Taoiseach defended the commitment, citing recent health funding and accusing Martin’s party of supporting a two-tier system.
I am looking for Government time to have this issue debated and I am entitled to do so on the Order of Business because we are getting queries on the cases we submitted to the Minister and because of the significant distress being caused to families.
Page 5 of the programme for Government relates to health issues and outlines the pathway to universal health care and insurance. Universal health insurance was proposed by either Fine Gael or the Labour Party as far back as 2002 and perhaps even earlier, but there has never been a detailed blueprint for costings or how it will be implemented. Five years ago, before the general election, we were promised it, but it was never costed and no detail was provided on it. Now it seems we are about to be told it will take another five years for the Government to even contemplate implementing it. The programme for Government stated that in the first term of the Government a foundation would be laid for the introduction of universal health care insurance and that the legislative basis for it would be provided, that public hospitals would be given autonomy from the HSE and that the HSE's function of purchasing care for uninsured patients would be given to a hospital care purchase agency which would combine with the National Treatment Purchase Fund to purchase care for the uninsured during the transition period. That was just one of the key commitments made in the programme for Government in terms of the legislative underpinning of universal health insurance. Will the Taoiseach confirm that none of this will now happen during the lifetime of the Government and that there is no detailed blueprint for the implementation of universal hospital care insurance? I will not mention the many other promises made in this regard.
We have been promised a review of the fair deal scheme and the system for financing it. The scheme has been under chronic pressure in the past 12 to 18 months. When will the review be published and what are the Government's proposals in looking after older people and in terms of access and eligibility for the scheme?
When can we expect publication of the apprenticeship Bill which will outline new governance structures for new apprenticeships and introduce protection for apprentices and outline the responsibilities of employers?
Comment on this
The Minister of State, Deputy Damien English, is dealing with the apprenticeship Bill and requested that all submissions be made by the end of March. I assume he is assessing the submissions and will obtain an update for the Deputy on when the Minister of State expects to put the Bill together.
As the Deputy is aware, the Government made a further allocation in the health area recently, of €75 million, to deal with issues related to the fair deal scheme and, I hope, reduce the waiting period to an average of four to five weeks. This will be more acceptable than the existing waiting period of 18 to 20 weeks. The Minister for Health will deal with the question of the review of the fair deal scheme, but I cannot provide a date of publication of the review. It will, obviously, be discussed in the House.
Universal health insurance will not be introduced during the lifetime of the Government. The Government has made it clear that it must be delayed because of the complexity of what is involved. The Minister has said he expects to be in a position to produce a paper on costings by the middle of the year. The Deputy is aware that hospital groups have been set up and that they will evolve into trusts. The money follows the patient concept is in place; primary care centres are being opened and agreement has been reached on GP cards for children under six years and people aged over 70. Being able to deal with people's medical needs based on medical requirements as distinct from how much money they might have is the essence of universal health insurance, but this cannot happen until all of the elements are in place.
Comment on this
What the Taoiseach is saying is that five years since the Government proposed this measure, it still does not have the costings.
Comment on this
The Government still does not have costings for something it promised the people five years ago.
Comment on this
The Deputy is getting a reply to his question. I must move on to Deputy Gerry Adams. We are not having a debate on the issue.
Comment on this
The commitment to the introduction of universal health insurance is not being reneged on.
Comment on this
Five years on, the Government does not even have costings.
Comment on this
There are plenty of other ways of raising the issue, apart from shouting across the floor.
Comment on this
Do not mind our party; the Government promised this measure five years ago
Comment on this
Will the Deputy, please, settle down? He must obey the rules just like everybody else, regardless of whether he believes it. I call on the Taoiseach to complete his response.
Comment on this
The Deputy's party supports a two-tier system and increasing income tax to make people pay more. Universal health insurance is the way forward.
Comment on this
The Government has no costings five years after it told the people it would be provided.