Dáil Éireann debate -
Wednesday, 13 Nov 2013

Vol. 820 No. 4

Leaders' Questions

Deputy Micheál Martin

Thousands of people are leaving the health insurance market on a monthly basis. Up to 6,000 people a month are cancelling their health insurance policies. By the end of 2013, we estimate 140,000 people will have cancelled health insurance. The bottom line is Government policy is driving people out of the health insurance market. Families and individuals can no longer afford policies. We only have to look back to the budget and the Minister for Finance's decision to reduce significantly tax relief on health insurance policies, which had a huge impact on many people. He pretended that the measure was for gold plated insurance policies but we now know that was an untruth as it affects up to 90% of policies. An additional bill of €30 million will flow from the decision to charge patients with health insurance for using public hospital beds and that will lead to another significant increase in the cost of health insurance. Earlier, the Minister for Health made an announcement, about which we learned through the media, that a 15% stamp duty increase would be levied on policies. Cumulatively, in the short space of two months, the Government has increased the cost of the average health insurance policy by €400. In many cases, the amount will be higher.

The Taoiseach and the Government knew when they took their budget decision on health insurance that this increase was coming down the road in the context of risk equalisation. They knew that when they decided to go heavy on reducing tax relief on insurance and the utilisation of public hospital beds. Was one increase not enough given all that is happening in the health insurance market? Why is the Taoiseach hammering hard pressed families who are of the view that they are paying for everything anyway without this additionality? Will he change policy and reverse the budget decision to reduce tax relief on health insurance policies and restore the relief to its pre-budget level?

The Taoiseach

It is never an easy position to have to draft budgets in an area like this given the circumstances in which we find ourselves. I detect from the Deputy's question that he has changed policy in this regard. It appears that he is advocating the abandoning of risk equalisation and community rating.

Deputy Mattie McGrath

Freagair an cheist.

Deputy Micheál Martin

No, I did not say that. I referred to budget tax reliefs.

The Taoiseach

If that is what the Deputy is saying, he is denying reality in that 20,000 people a year become 65-----

Deputy Niall Collins

Deputy Martin asked a straight question.

Deputy Micheál Martin

I said nothing about that.

The Taoiseach

The Deputy seems to be implying that there should be a change in Government policy, which would abandon older people to be manipulated by health insurance companies because they, naturally, might well have higher costs in terms of their medical requirements and the treatment they need. The clear objective of the Minister for Health is to reform the health service to deliver a single tier service in a way that allows for older people to be charged the same rate for the same policy as people who are much younger. That is community rating delivered through risk equalisation. If the Deputy is advocating a change in that, let him say so.

Deputy Niall Collins

He did not. Be honest for a change.

The Taoiseach

It is clear we should not underestimate this issue. Every year, 20,000 people reach the age of 65, which equates to 3.3% annual growth compared with overall growth of 0.5%. In 2003, only 13% of those who had health insurance were aged over 60. That increased to 15.9% in 2009 and to 19% in 2012. It is a fact of life that our population is ageing and we will retain community rating and not have a situation where older people in our society are manipulated by health insurance companies that will seek to present health plans that effectively abandon the older population. We cannot and we will not do that.

Even in these straitened times, the Government still provides €400 million in support to policyholders through the tax system and €400 million in a subsidy to the public beds system because we do not charge for the full economic cost of beds in hospitals. While these things are never easy, we must and will maintain community rating and risk equalisation in order that the older people in our society are not abandoned.

Deputy James Reilly

Hear, hear.

Deputy Micheál Martin

The Taoiseach chose to ignore the question I asked. Will he change policy on the budget decision the Government took to reduce tax relief on health insurance and restore it to its pre-budget level?

The Taoiseach

No.

Deputy Bernard J. Durkan

It costs money.

Deputy Micheál Martin

I never said anything should be abandoned in regard to community rating. The Taoiseach deliberately threw that out there to distract and to go down a cul-de-sac. That is a very dishonest presentation by him. That is fair enough; we are used to that.

The bottom line is if he is sincere about maintaining community rating, the haemorrhage cannot go on. Government policies are driving the haemorrhage from the system. A total of 64,000 people left the health insurance market in 2012. It is estimated 75,000 will leave by the end of 2013. Does the Taoiseach honestly think that increasing fees by reducing tax relief and charging for the utilisation of public beds by health insurance holders, even though they pay their taxes, will help community rating? Anybody who knows anything about the health insurance market is talking in terms of a death spiral, which means that when younger, healthier policyholders are taken out of the system, the burden on the older policyholders will increase to make it untenable. The centre will not hold if the haemorrhage of people from the health insurance market continues. In the meantime, the Government is making life unbearable for hard pressed families through this unfolding, incoherent, ad hoc policy.

The Minister for Health said he did not know that the Minister for Finance was going to do what he did on the taxation side of the budget and he was not consulted. That reveals the incoherence at the heart of Government policy on health and health insurance generally. Will the Taoiseach reverse the budget decision to reduce tax relief? By doing so, he would give much needed relief to people and give them some chance of holding on to their health insurance policies.

The Taoiseach

The answer to the Deputy's question is "No". That is the second time he has quoted Yeats in the House in the past fortnight, which I think is good. The newer insurers do not have older people. The Deputy cannot have it every way. Newer insurers cannot just expect to have younger people who, naturally, require less medical attention than older people.

Deputy Billy Kelleher

That is what community rating is about.

The Taoiseach

I am glad he has reversed again. He started with an implication about the abandonment of risk equalisation and community rating.

Deputy Micheál Martin

I did not. Do not be dishonest.

The Taoiseach

Even in his own days as Minister for Health, the Deputy adhered to that. That is something we have to support.

Deputy Billy Kelleher

The Taoiseach is having a Roscommon moment.

Deputy Frank Feighan

I will bring the Deputy to Roscommon. I am sick and tired of Opposition Members taking cheap shots.

The Taoiseach

We cannot have a situation where older people are abandoned and health insurers can present plans that are not suitable for older people.

Community rating and risk equalisation are a very important part of this for older people. Some 20,000 people reach 65 years of age every year.

The consultative forum set up by the Minister for Health to deal with this will report before Christmas and we will debate the report here. We will talk about retaining young people and young families, which are hard pressed in so many ways within the health system-----

Deputy Micheál Martin

The Government is driving people out of that market.

The Taoiseach

------and also how the health insurance companies can reduce their costs.

Deputy Micheál Martin

The Government is increasing the costs.

The Taoiseach

Why is it that in 2013 we are still paying the same charges for procedures which 20 years ago used to take quite a long time and required days in hospital but which can now be done in a relatively short time? Cataracts are now dealt with in 20 minutes. Why is it that the costs are still the same? What is going on here? Why is it that I hear so many stories every day from people who go through the health system? The charges seem to be very erratic, to put it mildly. There is a requirement on us all to debate the report of the consultative forum and the recommendations therein, which will be available in four to five weeks.

Deputy Martin will recognise, as a former Minister for Health, that there is clearly a need to reduce costs. There is no extra money coming into the Exchequer as a result of this. This money stays in the pool and extra credits are given to those who are over the age of 65. That is why it is very important to retain the community rating and the risk equalisation system.

(Interruptions).

Deputy Gerry Adams

The Taoiseach is aware of the concept of bridge building as a metaphor for what we need to do on this island, North and South, and within the North itself. He will also be very aware that a very practical project has been in the making for the past 30 years which would bridge the North and the South and has the support of all the political parties in Counties Louth, Down and Armagh and across all civic and community sectors and society. Obviously, I am talking about the Narrow Water Bridge proposal.

At last Friday's North-South Ministerial Council meeting, Ministers were supportive of this project. The economic benefits of this infrastructural investment for communities on both sides of the Border are considerable, and at a time when the construction industry needs investment to create real jobs. The building of this bridge is a relatively small investment with significant potential. In the short term, it will deliver 270 jobs and in the longer term, the entire region will have a massive economic stimulus from the Cooley Peninsula and Slieve Gullion across Carlingford Lough to the Mourne Mountains. Support from the Special European Union Programmes Body is evidence of its importance.

I have raised this issue with the Taoiseach before and I know he supports it but the deadline keeps slipping. According to Louth County Council, the contractor is only obliged to hold the contract price until 16 December but he has agreed to extend it until 18 January next. Can the Taoiseach help to end the uncertainty over this vital infrastructural project and agree to release the funding which will bring it to completion?

The Taoiseach

Fáilte abhaile roimh an Teachta. Tá súil agam go raibh turas maith aige.

The Narrow Water Bridge is the first manifestation of physical contact between North and South that has been put together for very many years in this area and which is supported, as a principle, by practically everybody. Deputy Adams will be aware that the estimate for the cost of the provision of the Narrow Water Bridge to Rostrevor was approximately €18 million and that the tenders which came in were very much in excess of that.

In terms of what needed to be done, clearly, Louth County Council has an issue, as do Newry and Mourne District Council, the Northern Ireland Executive and the Government here. A value for money report was done which estimated that the bridge is a viable proposition and entity. The problem is the scale of the tenders being in excess of the scale of the estimate but I am not qualified to go through the detail of that.

The moneys provided from a European Union perspective, through the SEUPB, were allocated for the provision of the bridge in a certain timescale and we do not want to lose this money. This matter was discussed at the North-South Ministerial Council in Armagh on Friday. Agreement was reached between all the parties - everyone continued to support the provision of the Narrow Water Bridge - that there would be an immediate analysis of the extent of the tenders submitted and the reasons they were so extensive and that discussions would be held with the SEUPB. That is where it lies at the moment but there was a general consensus strongly in support of the Narrow Water Bridge.

To be honest with the Deputy, I am not quite sure if it can be dealt with in the timescale mentioned here. There was a question of piling on either side of the lough. I do not know the answer to the Deputy's question but I know the Government here supports this, as do Louth County Council, Newry and Mourne District Council and the Assembly in Northern Ireland. It is a question of having the money in place, doing the analysis of the tenders and arriving at a position where this allocation from a European Union perspective is not lost to the region. I would like to see the Narrow Water Bridge provided but I cannot say at this stage whether the timescale to hold this particular tranche of money is sufficient. However, there is work going on, as a consequence of the North-South Ministerial Council, on the analysis of the tenders and the extent of those received.

Deputy Gerry Adams

Fáilte abhaile roimh an Taoiseach fosta.

I thank the Taoiseach for his answer. Clearly, what we need is a decision. I understand this analysis has to be done but it would be a sin if the cocktail of funding that has been put together was lost. The Government has said - the Tánaiste said this very recently - that we need to take the brakes off all-island economic development. The Government also quite correctly said disadvantage is very prominent along the Border and along the Border corridor and that people there have suffered grievously because of partition. This is a very practical example of a lot of hard work done over a very long time. It is very unique to get so much co-operation among all the different sectors involved, which the Taoiseach acknowledged in his answer.

We have until 18 January to crunch this. Basically, what is required from the Government is €6 million from the Department of Transport, Tourism and Sport, the Department of the Taoiseach or the Department of the Environment, Community and Local Government or some arrangement around other incentives which could be put in place. Will the Taoiseach make this happen?

When one gets the Assembly, the Executive and the Government here joined up in this way, if the Taoiseach decided to make this happen, it would happen. I appeal to him to do so. I understand the difficulties involved as I am heavily involved in this. Sinn Féin has been campaigning on this matter. It is very much up to the Taoiseach to take this as a very concrete example of building a prosperity process out of a peace process. We talk about stimulus, about getting the construction industry going and about exploiting, for the sake of our citizens, the tourism and other potential in some of these areas. This is a classic case of where that can all happen if the Taoiseach decides to make it happen.

The Taoiseach

To be honest with the Deputy, I would like to see it happen but I think we have to go through the analysis of the tenders. As I said, there was a shortfall of approximately €15 million between the estimate and the tenders that came in.

I know the local authority in Louth has convened a meeting this Friday to discuss how this might continue to be supported along with Newry and Mourne. I think that is good. I assume it will not have on its desk the analysis of why the tenders were so greatly in excess of the estimate that was received in the first place. It is not a case of the Government or the Department here deciding to take full responsibility for this. There was always the shared concept of doing this. Having spoken to personnel from the Assembly and the Executive, I am aware that the value for money report which has to be conducted from Stormont has to satisfy the Chancellor of the Exchequer's office. I think they need to look at that again. They will do so in the context of how flexible it can be made and in accordance with the report of the Special EU Programmes Body, which says that it is a viable entity. It is not a question of unwillingness on the part of the Government or the Department here. I do not think it is a question of unwillingness on the part of the Executive. It is a case of keeping the bridge concept and principle very much alive. My immediate concern is that the European moneys were allocated for a specific time. Neither the Deputy nor anyone else would want those moneys to be lost to the region. We will see what can happen in the short term, in terms of the analysis of the tenders and whether further progress can be made. My answer to the Deputy's question is that we are willing to support it, but we need to have clarity regarding how it is shared. I think that sentiment is shared by the North-South Ministerial Council.

Deputy Stephen S. Donnelly

We are halfway through the Committee Stage debate on the new freedom of information legislation. I accept that the new Bill contains some meaningful reforms. Unfortunately, all of the potential good that the Bill could do will be eradicated by the changes in the fees regime. I believe the Government set out to do the right thing. I remind the House of what the current Minister, Deputy Bruton, said in 2003 when Fianna Fáil sought to eradicate the then freedom of information regime. He said there should be "a right to make requests without a fee upfront, with a person only paying for the cost incurred by his or her request". In the same year, the current Minister, Deputy Rabbitte, said "it is abundantly clear that the fee is primarily intended to discourage requests being made in the first instance".

Deputy Mattie McGrath

He has changed his mind.

Deputy Stephen S. Donnelly

In 2008, when the current Minister of State, Deputy White, was a Member of the Seanad, he said "the presumption in any democratic society...should be to make the information available". He argued that "it is not good enough for a Minister to point to the extraordinary cost or how onerous it is on us". The changes that are proposed in this legislation are contrary to the position of the UN Human Rights Committee and the Council of Europe Convention on Access to Official Documents. International experts are no more ambiguous. Article 19, which is a human rights organisation that focuses on freedom of information, has said it "strongly opposes the current Irish policy...as well as the pending bill before the Dail to expand fees". It believes it violates international law. According to a Canadian journalist and author, Cory Doctorow:

Irish politicians have taken extraordinary measures to protect the state from the people finding out what it's up to. This is alarming on its face, and would be bad news even if Ireland was a paragon of good governance, and not a nation in economic meltdown.

The Government's new Bill introduces a range of new charges and impediments. It retains the up-front fee of €15 for non-personal records. It provides for a retrieval cost of €21 an hour. It introduces multiple fees for multifaceted requests. It introduces multiple fees for single requests that have to go to more than one functional area. It retains a fee for internal appeal and a fee for appeal to the Information Commissioner. In short, the freedom of information legislation that is before the committee will make freedom of information more expensive. Why is the Government increasing freedom of information costs even though domestic and international experts are clear and unanimous on how bad that is? We have unparalleled information on how and why secrecy is bad in this State.

Deputy Finian McGrath

Can the Minister, Deputy Bruton, answer that?

The Taoiseach

Thousands of national and international experts have been available to us in respect of many matters.

Deputy Patrick Nulty

Just answer the question.

The Taoiseach

It is quite incredible. They have been telling us what is going to happen about the economy and various matters relating to Europe for a long time.

Deputy Mattie McGrath

What does this have to do with the question?

The Taoiseach

Sometimes, experts do not get it right either.

Deputy Patrick O'Donovan

Present company excluded.

The Taoiseach

Deputy Donnelly's first point is correct here. Along with his Government colleagues, the Minister, Deputy Howlin, has extended the remit of the Freedom of Information Acts to a range of areas that were not covered before. I think that is welcome.

Deputy Dara Calleary

The Minister, Deputy Bruton, has done a U-turn.

The Taoiseach

It should be borne in mind that 70% of applications received by freedom of information offices relate to personal matters and are therefore dealt with for free. It should be recognised that the first two hours of analysis of any freedom of information request is done for free. If the issues involved can be dealt with in that timeframe, there is no charge at all. Many freedom of information officers have informed me of the current position, which is that a page asking about a certain issue might contain a further 20 or 40 requests that are hidden behind the first request. It can take a great length of time for the relevant official in the relevant Department to deal with it. An itemised charge will apply in such circumstances if it takes more than two hours to deal with each item and if the matter in question is not of a personal nature. Dealings with such matters will of course remain free. When I was on the other side of the House, a Deputy submitted a freedom of information request relating to a justice matter and the estimated cost of dealing with it was over €9,000. It was a very complex case going back a number of years.

Deputy Barry Cowen

What happened in that case?

The Taoiseach

People are fully entitled to send in freedom of information requests. When lists of things that are completely unrelated are sent in on a single page, the view taken is that each separate matter constitutes a separate request. If it takes less than two hours to deal with any of those matters, or if any of them relates to a personal matter, there is no charge. It is a case of reflecting that reality. The freedom of information regime is being extended to reverse the measures that were introduced some years ago with regard to Cabinet records, communications between Ministers, the scope to withhold all records pertaining to the deliberative process and the mandatory blanket extensions that apply to security, defence and international relations matters. The new freedom of information Bill reverses a great deal of these measures. I think that is in the public interest.

Deputy Stephen S. Donnelly

I thank the Taoiseach for his reply. Unfortunately, he did not answer my question. The only rationale we seemed to get from the Minister, Deputy Howlin, yesterday was that at a time of economic hardship, we cannot make freedom of information, which is an essential part of any modern democracy, free. We have received a very thorough report from Dr. Nat O'Connor which estimates that the cost associated with charging money in these circumstances is at least as much as the money that is received. That is before many of the savings that are made on foot of investigative journalism are factored in. As we know, such good work saves the State millions of euro. There is no argument that says we have to charge fees because it costs money. The amount of money it costs to charge the fee is as much as the fee itself. Therefore, my question stands. If the State does not get a cash benefit from charging citizens to access information, why are we charging them? Why is the Taoiseach standing over legislation that will increase the cost of people getting that information? That is the question.

Deputy Richard Boyd Barrett

Freedom means free.

The Taoiseach

As I said, 70% of the claims that come in relate to personal information and are therefore dealt with for free.

Deputy Finian McGrath

This is a power grab.

The Taoiseach

If it takes less than two hours to deal with a freedom of information request about a single issue, there is no charge.

Deputy John Halligan

That is why it is called freedom of information - it is free.

The Taoiseach

The legislation makes it clear that in the case of a single request, if other requests are made on the same page and are related to the initial request, they are all seen as part of the same claim. It appears that significant numbers of claims that include various unrelated matters are being made. Other countries that are deemed not to have upfront charges have other charges during the process. I think I should repeat that we have changed elements that were blocked off before.

Deputy Richard Boyd Barrett

Not the semi-States.

The Taoiseach

The areas that were off limits for a long time include the National Treasury Management Agency, the National Asset Management Agency, Garda Síochána, refugee agencies-----

Deputy Patrick O'Donovan

Deputy Finian McGrath was in government with Bertie when that happened.

The Taoiseach

-----and a very broad range of quasi-judicial bodies to which freedom of information only applied to their administrative records.

Deputy John Halligan

It should not be called freedom of information if it is not free. That is about the size of it.

The Taoiseach

That is all being opened up.

Deputy Billy Kelleher

The Government will be charging us for parliamentary questions next.

The Taoiseach

As the new legislation takes effect, given that the average cost of retrieving information is about €600, a €15 charge is relatively small.

Deputy John Halligan

It is not free; it is not freedom of information.

Deputy Niall Collins

It is centralising power.

The Taoiseach

I believe that when people make claims, they focus on a single issue with related matters or a series of different issues. That is the reason the legislation is framed as it is in extending the remit of freedom of information.