I would like to join with the Taoiseach in welcoming the publication of this white paper, which will provide the framework for a major consultation on the most significant reforms to our health service in a generation.
The Labour Party was the first political party in Ireland to propose universal health insurance, based on multiple insurers, back in 2001. We elaborated on that policy in detail again in advance of the election in 2011. Our spur then – as now – was the inequity, and the inefficiency, of Ireland’s two-tier health system.
My party believes that a person’s access to medical care should be determined by their medical needs, not the money in their pocket. Put simply, universal health insurance is about providing equal access for all of our people to quality healthcare services, and providing the right incentives for them to get treated as early, and as efficiently as possible.
The unfair two-tier system that has determined the course – and many of the problems – of our health service over many decades, is not working.
It does not work for people who cannot afford private health insurance, and who find themselves at the back of the queue for a consultant’s appointment.
It does not even work for those hard-pressed families who struggle to pay for private health insurance, only to find their premium is going up every year, while their benefits are going down.
It does not work for the staff of our health services, who do a remarkable job in the face of enormous challenges – and who will be the first to point out where scarce resources are being wasted.
And it does not work for the taxpayer, who pays three times over for the same service – through their taxes, through their health insurance, and through their out of pocket expenses.
Three out of every four euros collected from income tax will be spent on the health services this year. I believe that people deserve a better service for their investment.
When the Labour Party first proposed universal health insurance as a means of reforming both access to the health services, and how those services are funded, public health spending was 7.2 billion euro. Six years later, in 2007, it had grown by six and a half billion euro. Yet it continued to be beset by long waiting lists, overcrowded wards, and budget overruns.
Reform on this scale is never easy. And it has been made harder by the fiscal crisis. But what the boom demonstrated, is that you can keep putting money into a broken system, but if you don’t fix the root of the problem, very little will change.
This is the first Government to face up to fixing the root of the problem. It is the first Government to agree to develop a universal, single-tier health service. The first Government committed to a system that will guarantee access to care based on need, not income. And it is the first Government to commit to universal GP care, because that will incentivise the delivery of care early, and efficiently.
Change does not happen overnight. It happens piece by piece, and pillar by pillar. In particular, as we contemplate wider reform, we need to make sure that the taxpayer is getting value for money for the considerable investment they are already making in the health service. I want to congratulate Minister Reilly for the reforms he is already undertaking, to create a health service that is more efficient, and more effective for patients. In particular, the development of Money Follows the Patient; the work of the Special Delivery Unit in reducing waiting lists; the development of regional hospital groups; and the ongoing work to tackle the rise in health insurance costs.
I would also like to take the opportunity to commend Minister of State Kathleen Lynch, for the work she is doing in building up mental health services in particular, progressing recruitment of over 670 new posts since 2011. And I would like to commend also Minister of State Alex White, for his work in building up primary care services, and who will very shortly be bringing forward legislation to give children aged five and under access to GP care without fees.
There is no doubt that the challenges of reform are many. But so are the rewards. The price of inaction is more of the same: more of the same problems, and more of the same inequality. As a Government, we have been clear about our objective: a single-tier, universal health service, where access to medical care is based on need, and not income. The publication of today’s white paper, and the launch of the consultation process, is the first step of many on the road to that historic goal.