I thank the Taoiseach's officials for their behind-the-scenes engagement over continuing recruitment anomalies for our cardiology services at University Hospital Waterford, UHW. Hopefully, there will be no further snafus with building on the Taoiseach's promise to the people of the south east.

It is fair to say that we had all better keep a beady eye on the delivery of these future approved appointments.

With that in hand for the moment, it allows me to use my time to address an issue of national importance, that is, our dysfunctional insurance market. Insurance, the contributions of the many for the losses of the few, is supposed to make our society more resilient. Our Minister for Health, Deputy Stephen Donnelly, was not wrong when he observed that we do things in life, such as playing sport or throwing a child onto a trampoline, that inherently carry a risk. We have got to manage that risk. Increasingly, commercial business, not-for-profits, schools, the Government and families are finding it hard, and that they can do less in life, because insurance is not working. This is déjà vu from 20 years ago.

Occupiers' liability remains extraordinarily onerous. If something happens on your premises, you are to blame, irrespective of the circumstances. Nothing has happened on the reform of occupiers' liability, despite it being in the justice action plan. The ink is barely dry on the personal injuries guidelines committee award levels and they are already being circumvented. There appear to be no repercussions for making persistent nuisance, or even downright fraudulent, claims. Cases take too long and take too much out of the people involved in them. Simply put, insurance costs too much and for many it is becoming impossible to obtain at any reasonable economic cost. Indeed, what is becoming a parasitical insurance-medical-legal industry crushes the social, cultural and economic vitality of our society. It is no surprise that that honeypot crushed the troika back in the day.

It is surely time to grab the nettle and stop tinkering with tort reform but replace tort compensation with a sturdy social security framework that serves victims without respect to cause or fault. Tort reform was legislated for in Australia a decade ago and has delivered for that society. We must do something similar in Ireland.

I thank the Deputy for his query. I noted his comments regarding the cardiac situation in Waterford, which we will continue to pursue vigorously. I am conscious another Waterford Deputy and Minister is sitting adjacent to me, who is also advocating strongly for that. I take the Deputy's point on the issue.

On insurance inform, I have a lot of sympathy with the Deputy's comments on the impact of insurance costs on employment, business and enterprise. That is why it is a key priority for the Government. The action plan for insurance reform was published in December 2020. It sets out 66 actions to bring down costs for consumers and businesses, introduce more competition into the market, prevent fraud and reduce the burden on enterprises and community and voluntary organisations. Some 95% of the actions are due to be completed by the end of 2021.

The first action plan implementation report, published in July, shows that tangible progress has been made. The introduction of new personal injury guidelines is one example. Early data from the Personal Injuries Assessment Board demonstrates that award levels have declined by an average of 40%. I take the Deputy's point that we need to see that translated into premium reductions. An office to promote competition in the insurance market has been established, chaired by the Minister of State with responsibility for financial services, credit unions and insurance, Deputy Sean Fleming, who is doing exceptional work on this topic. The Criminal Justice (Perjury and Related Offences) Act 2021 passed all Stages on 15 June. This will make perjury an offence for the first time and will, therefore, help tackle insurance fraud. An insurance fraud co-ordination office has been established within An Garda Síochána.

The Deputy identified the issue of occupiers' liability. He will know that the Department of Justice has recently completed a review of the Occupiers' Liability Act, which included the issues of duty of care, notices and waivers. The Minister for Justice, Deputy Helen McEntee, has noted to Government the intention to bring forward legislative proposals to reform the law in this area. Those proposals are at a very advanced stage. The Minister has indicated that the heads of the relevant amendments have been drafted and advice has been sought from the Office of the Attorney General. The planned rebalancing of duty of care with a view to applying a common sense approach to risk is of particular relevance to leisure and high-footfall activities, as it will help to address so-called slips, trips and falls.

The Minister of State, Deputy Troy, is progressing development of a general scheme of legislative amendments to increase the number of cases which are settled by the Personal Injuries Assessment Board, PIAB, without recourse to litigation and he is working in consultation with the Attorney General on the reform of PIAB and legislative reforms in that regard. A comprehensive programme of action is under way.

The issue will be, as those reforms are implemented and given effect to, whether we can translate those reforms. We need to ensure the translation of those reforms into reduced costs for people, such as households, community and voluntary groups and businesses.

Insurance is not working, as the Taoiseach knows. It is becoming unaffordable and unavailable for a significant number of sectors. Many only have recourse to one underwriter and they have to pay whatever is being asked of them. The Taoiseach mentioned PIAB and he knows PIAB claims are being circumvented with the attachment of post traumatic stress to soft tissue injuries. That was never meant to be where we were going in terms of the personal injuries guidelines committee, PIGC. There has been no attachment of costs to solicitors' practices bringing nuisance cases. I have not seen any and, in fact, there was one high profile case recently where the judge explicitly refused to do this. It related to GAA insurance.

The insurance companies are not settling. They are settling low-pay costs because they do not want to go to the High Court and even when they are getting awards, they cannot recover the costs from the other side. This is leading to this large level of dysfunction. When the Taoiseach talks about claims falling, what he is really talking about is the motor insurance industry. That is the only heading where insurance claims appear to be falling and where premiums are falling. They are not falling anywhere else. I have a friend in the sports amenity business who is facing a claim from somebody who broke through a fence, came into the property at night and injured themselves. My friend is facing a personal injuries claim, as an occupier.

Unfortunately, this is endemic throughout the country if one looks at where the courts are going. It is being supported, unfortunately, by many in the legal profession and we will have to legislate again and properly on insurance reform beyond what we are doing.

I thank the Deputy for raising what is a very important issue for people and it is part of a wider agenda within Government to reduce costs for people in their ordinary lives. Insurance is a significant cost, whether one is in a household, motoring or in a business. The Deputy was correct to point to the reduction in motor insurance. This morning, the Government again adopted a significant road safety strategy for the coming years. It is interesting when one looks at the number of people who died on our roads 20 years ago compared to now. The number is stark - in other words, it is far fewer now. I stand corrected on the figures but it was something like 450 per annum but it is approximately 150 now, which is still too many. However, it illustrates what good strategies and reforms can achieve. I recall the howling in the House when the then Minister was introducing drink driving laws and so on. Deputies were opposing them. Noel Dempsey was the Minister at the time and the late Gay Byrne headed up the RSA. However, the results are there to be seen in reduced road fatalities and accidents. Strategies work. The agenda we have for insurance reform is comprehensive and will work, but we have to keep the focus on it and make sure it works and translates into reduced costs.