Dáil Éireann debate -
Thursday, 30 Jan 2014

Vol. 828 No. 3

Leaders' Questions

Deputy Billy Kelleher

Yesterday VHI Healthcare announced its fourth price increase in three years. I have no doubt that other health insurers will follow suit in the near future. It could be perceived that this Government is in cahoots with insurers in efforts to drive as many families as possible out of the health insurance market. More than 6,000 people a month are giving up private health insurance. The number leaving exacerbates the problem of providing a sustainable health insurance model. This Government has committed to the implementation of universal health insurance but all policies pursued by the Government have undermined families in their efforts to retain their private health insurance.

Last night I raised the issue of the costs charged by some private hospitals to private health insurers. In one case a private hospital billed an insurance company €17,000 for one night's accommodation with a bill of €2,000 for surgical procedures.

The Tánaiste's policy for universal health insurance would ensure that as many people as possible would retain private health insurance while the Government would pay the premiums for those who cannot afford to pay. However, the situation seems to be unsustainable. Families are making decisions on whether they will stop paying for private health insurance or else not fill the tank with oil or gas or make other basic cuts in household expenditure in order to fund that private health insurance. This expenditure on private health insurance is not a luxury. The Government encourages people to take out private health insurance but every other policy decision undermines them.

Will the Minister for Finance reverse the cap on tax relief for private health insurance, in view of the fact he said only gold-plated health insurance policies would be affected? On the contrary, it is affecting every family in this country currently attempting to retain their private health insurance. Will he reverse that attack on ordinary families?

The Tánaiste

The recession has been very tough on working families. The last thing families need now is an increase in the cost of private health insurance. At a time of increasing competition in the market and with new players seeing the opportunity for themselves, I share the wonder expressed by many people as to why prices are going up and not down. The Deputy will be aware that the Government has no legal power to intervene in the pricing set by VHI or any other insurer. However, we are very concerned about the cost of standard health insurance for hard-pressed families. That is the reason the Minister for Health, Deputy James Reilly, set up a consultative forum under an independent chairperson, Mr. Pat McLoughlin, to work with health insurers, the Department of Health and the Health Insurance Authority on the issue of containing costs. Mr. McLoughlin's report on the first phase of this work was published on 26 December 2013. He has started on the next phase of the work which is a study in greater depth of the key drivers of rising costs and how these can be addressed. He will report within three months.

The first McLoughlin report on costs made recommendations in a number of areas, including adopting a co-ordinated approach to identifying and tackling fraud in the industry. It published data on funds recovered from hospitals and consultants. The report also calls on the industry to fund a whistleblower initiative to assist in uncovering fraud. The report acknowledges the important role of clinical audit in identifying unnecessary claims. It is vital the industry makes best use of this tool to address rising costs. The report calls on insurers to make better use of existing information sources to challenge payments, in particular in respect of the most appropriate places for providing treatment, to ensure patients receive quality treatment at the lowest possible cost. Implementation of the policy of money following the patient will support this action by replacing daily charges with case-based charging.

Addressing the age structure of the private health insurance market is also important. The Minister for Health, Deputy Reilly, is considering measures to encourage more young people into the market, including the introduction of lifetime community rating to encourage younger people to take out private health insurance. The industry can make better use of existing legislation by discounting premiums for full-time students under the age of 23. The report also makes a number of recommendations about the processing of claims and admission and discharge procedures. The Minister is committed to progressing these recommendations in consultation with stakeholders. The Minister supports Mr. McLoughlin's recommendations and is committed to making progress in this area.

Deputy Billy Kelleher

We appreciate the Tánaiste sharing in the wonder but we would much prefer if he shared the responsibility for the escalating costs of private health insurance. Every Government policy is inflating the cost of private health insurance for hard-pressed families. I agree that because of the recession there is high unemployment and the country is in difficulty. The bottom line is that the Minister for Finance, with one fell swoop, drove thousands of people out of the private health insurance market. The spurious claim that this would only affect gold-plated health insurance policies is not credible. Every family in the country will be affected by the cap on tax relief. The Tánaiste's reply to my question gives no comfort to any family deciding whether private health insurance can be retained.

Does the Tánaiste agree that the Government is undermining the health insurance market? The debt spiral continues and hard-pressed families are finding it increasingly difficult to retain private health insurance. The Government's policy is undermining intergenerational solidarity, community rating and the subsidising of the old by the young. I ask the Tánaiste to reverse the tax relief cap and consider introducing a policy to attract young people into the private health insurance market before it crumbles.

The Tánaiste

There is a problem of rising premia costs in the private health insurance market. The Government is taking its responsibilities seriously with regard to rising health insurance costs. As a consequence, the Minister for Health established the forum under the chairmanship of Mr. McLoughlin. The initial report identifies a number of areas that need to be tackled and addressed. A further body of work is under way and will report within three months.

There are a number of aspects to the issue of rising costs in the health insurance market, one of which was instanced by Deputy Kelleher. I do not understand why a health insurance company should receive a bill for €17,000 for one night in a hospital. This is one of the issues which needs to be examined.

Deputy Timmy Dooley

The Tánaiste is in a position to find out.

The Tánaiste

The problems associated with rising health insurance costs and health insurance premia are not new. The Government is determined to get to the bottom of what is driving the rising cost of health insurance and to try to get it under control for families who are under pressure trying to pay for it. Part of the problem is to do with over-charging and with the competition for the young, healthy people-----

Deputy Billy Kelleher

The budget had a lot to do with it.

The Tánaiste

The budget has nothing to do with it.

An Ceann Comhairle

We are over time.

Deputy Billy Kelleher

Every family's health insurance policy is gold-plated, according to this Government.

The Tánaiste

That is just taking a political swipe. There is an issue about the cost of health insurance premiums and the Government is addressing it.

Deputy Dara Calleary

Ninety per cent of premiums.

Deputy Timmy Dooley

That is why they are being increased by 5% today.

Deputy Mary Lou McDonald

By any standards, Louise O'Keeffe is an extremely courageous woman. Abused as a young child and, no doubt, deeply traumatised as a result, blocked, bullied, browbeaten and threatened by the State, she never lay down. She took her case to the European Court of Human Rights and that court ruled this week that the Irish State is directly liable for the inhuman and degrading treatment of an eight year old girl. It further ruled that this State offered that girl, now an adult, no remedy for that abuse. The court could have gone much further. It could have said, correctly, that this State prevented any degree of fairness, justice or resolution of this case for Louise O'Keeffe.

Responsibility and liability of this State in this case has now been firmly established.

I hear that the Taoiseach has, in the past few minutes, said some words of apology to Louise, which is welcome. It should be said, however, that given the enormity of the wrong done to this woman and to others, those words of apology should have been uttered in this Chamber. Can the Tánaiste tell me whether that apology extends to those other victims of abuse in primary schools? I understand 135 other adults brought cases similar to that of Louise O'Keeffe claiming the Department of Education and Skills and the State did not provide protection and had a liability for the abuse they suffered. As the Tánaiste knows, following the Supreme Court judgment in 2008 in the case taken by Ms O'Keeffe, they received threatening letters telling them they would face legal costs unless they dropped their cases. Is that threat now removed? Can the Tánaiste tell me why last year the Government argued before the European Court of Human Rights that this State had no liability for what happened to children like Louise O'Keeffe? How is it that officials and counsel were sent, on the behalf of the State and this Government, to again attempt to face down this courageous woman?

The Tánaiste

Louise O'Keeffe should never have been subjected to abuse. She should have had a carefree childhood. Her case reminds us of the shocking scale of historical abuse, failures and inaction to protect children. I admire Louise O'Keeffe and I join with the Taoiseach in apologising to her for what happened in that school and for the horrendous experience she had to go through. We now have the judgment from the European Court of Human Rights, which is a very substantial one of about 82 pages, and we will discuss it at the Government meeting next Tuesday.

This Government has addressed clearly and comprehensively the whole issue of the protection of children. It is absolutely and without question a priority for the Government. We have created a dedicated Department of Children and Youth Affairs and have held a referendum on children's rights. Within the education sector, all schools are required to adhere to child protection procedures which give direction and guidance to school authorities and school personnel in the implementation of Children First when dealing with allegations and suspicions of child abuse. All primary schools now fully implement the Stay Safe programme, which plays a valuable role in helping children to develop the skills necessary to enable them to recognise and resist abuse and potentially abusive situations.

The Child and Family Agency is being officially launched today. It will be the first agency dedicated to supporting our children and families and to promoting the development, welfare and protection of our children. The Minister, Deputy Fitzgerald, has published updated Children First guidelines and led a national effort to improve awareness of the need to report child protection concerns, leading to a major increase in reports which are up by one third on 2011. The Minister has also published the heads of the Children First legislation and the revised Bill will be published in March. The legislation will place obligations on professionals and organisations working with children to report suspected child protection concerns, to share information and to engage in inter-agency and multi-disciplinary working. The Minister for Justice and Equality has also commenced the Criminal Justice (Withholding of Information on Offences Against Children and Vulnerable Persons) Act 2012 and it is now the responsibility of every member of society to protect and defend children from sexual and other abuse.

It is no longer acceptable, and it should never have been, that secrecy or ignorance on the part of those with knowledge of what were criminal offences could protect those who perpetrated those crimes. As I said, we will consider the implications of the judgment at the Government meeting on Tuesday.

Deputy Mary Lou McDonald

Not alone should Louise O'Keeffe not have suffered abuse at the tender age of eight in what should have been a very safe environment of her primary school, she should not have been harangued, bullied and threatened by the State. I am sure the Tánaiste will agree with me on that point but that is precisely what happened through the High Court, the Supreme Court and as far as the European Court of Human Rights. It was the Tánaiste's Government that argued the case against Louise O'Keeffe as recently as a year ago. That draws a very serious question over what he said in terms of child abuse being a historical issue. He lists the many legislative achievements, and I applaud them. They are long overdue and very necessary but so too is the necessary sea-change in terms of how the State responds to the Louise O'Keeffes of this world. There is an established pattern that the State and Government close ranks and try to shut down any call for justice from people like Louise O'Keeffe.

An Ceann Comhairle

A question, please. You are over time.

Deputy Mary Lou McDonald

Let it be said that all of the protections which now exist and are contemplated are a direct result of brave people like Louise O'Keeffe stepping forward. Can the Tánaiste answer my question? I asked him whether the Taoiseach's apology and his apology extends to all victims of abuse in primary schools. I would like to hear him say clearly that his Government and the State now fully accept that the State has a liability for the abuse suffered by all of these survivors and that it has a liability for any current or future instances of abuse of that nature.

An Ceann Comhairle

Thank you, Deputy.

Deputy Mary Lou McDonald

We can all agree on Louise's bravery-----

An Ceann Comhairle

Will you recognise the Chair?

Deputy Mary Lou McDonald

-----and on the significance of this judgment but what we need to hear from the Government now are clear words and the actions it intends to take-----

An Ceann Comhairle

Deputy, did you not hear me? You are way over your time.

Deputy Mary Lou McDonald

-----and an apology to one and all.

The Tánaiste

Again, I make it very clear that we apologise to Louise O'Keeffe. She should not have suffered what she suffered and I apologise to her for what occurred in that school.

Deputy Mary Lou McDonald

And in the courts.

The Tánaiste

As the Deputy knows, the Supreme Court handed down a judgment on this case, I think, in 2009, certainly some time before we came into office. That was the legal position at the time. The Deputy raised the issue about the State accepting liability for current and future cases in terms of what happens in our schools. There are very significant implications in the judgment of the European Court of Human Rights. We have had a system in this country of schools operating under a system of patronage. My understanding of the Supreme Court judgment in 2009 was that it accepted that system of patronage and, therefore, ultimate liability did not rest with the State.

The judgment of the European Court of Human Rights has very serious implications for the relationship between the State and the patronage of our schools. As the Deputy knows, the Minister for Education and Skills has already undertaken a process of considering the whole issue of patronage of our schools. That issue will now be given an added significance by the judgment in this case. That is one of the issues.

The Deputy raised the situation in terms of current and future responsibility by the State. That is among the issues that Government will have to consider arising from this judgment. The implications of it are profound for the patronage system of schools and for the relationship between the State and patrons of schools.

Deputy Mary Lou McDonald

The Tánaiste did not answer my questions.

Deputy Seamus Healy

The policies of successive Governments have allowed an elite golden circle of the rich and powerful in this country to obtain obscene levels of wealth at a time when the vast majority of people have seen their incomes reduced and have been struggling day in, day out to make ends meet. The message from last week's meeting in Davos and from the Paris School of Economics is that Irish society is becoming more unequal. We are hearing the same message from Oxfam, the Central Statistics Office and the Economic and Social Research Institute. That message is supported by the fact that many of the consultants who recently received substantial payments from Irish Water are the same companies and individuals who were paid for bad advice and bad oversight during the boom. The message is further reinforced by the payment of bonuses, the breach of pay limits for Government advisers and the payment of huge pensions. The list goes on.

In a recent study, the Paris School of Economics showed that the wealthiest 1% of people in Ireland own 10% of national income. Ireland is the seventh worst, in inequality terms, of the 18 countries studied. The figures for accumulated wealth are even more significant and stark. The wealthiest 5% of families in this country own 47% of the wealth. Since this Government came to power, the wealthiest 300 individuals in this country have gained €9 billion, or €30 million each. According to the Central Statistics Office, the incomes of the wealthiest 10% of people in Ireland have increased during the course of the recession, while the incomes of the other 90% of people have decreased. That fall has accelerated as incomes have declined.

An Ceann Comhairle

A question, please.

Deputy Seamus Healy

The Economic and Social Research Institute has independently studied the last three budgets and found them to be regressive, which means the budgets have taken the most from those who have the least. Low and middle income families-----

An Ceann Comhairle

This is a time for questions rather than speeches. Will the Deputy put his question?

Deputy Seamus Healy

I am putting the question now. Low and middle income families have had their incomes undermined. They have been fleeced by increased taxes, such as the unfair household tax. They are struggling to make ends meet.

An Ceann Comhairle

I will not ask the Deputy again to put a question rather than making a statement.

Deputy Seamus Healy

In those circumstances, how can the Government justify the introduction of a new regressive water tax to be paid by families that are already at their wits' end?

Deputy Finian McGrath

Hear, hear.

The Tánaiste

I share with Deputy Healy a wish to see equity in our society.

Deputy Peter Mathews

Then do it.

Deputy Finian McGrath

Good man, Peter. Give it some welly.

The Tánaiste

I want to see fair taxation that ensures those who are in the best position to contribute to the finances of the State do so. The problem is that every time we propose any measures in that regard, Deputy Healy opposes them.

Deputy Seamus Healy

Which ones?

Deputy John Halligan

What has this Government done to address inequality?

The Tánaiste

For example, this Government has introduced a number of measures to increase capital taxation. I refer to taxes like capital gains tax, capital acquisitions tax and deposit interest retention tax. To my recollection, Deputy Healy opposed all of those measures.

Deputy Billy Kelleher

The Tánaiste used to oppose water charges at one time.

The Tánaiste

When we introduced a property tax, my recollection is that Deputy Healy opposed that as well.

Deputy Joan Collins

The Tánaiste is talking about the family home tax.

Deputy Finian McGrath

The home tax.

The Tánaiste

I am certainly open to hearing from Deputy Healy specific proposals about taxation or other measures that will contribute to greater equity. There is no point coming into the Dáil to bemoan inequality and excessive wealth and then opposing every measure that is introduced to deal with those issues.

Deputy Billy Kelleher

That was the reserve of the Labour Party when it was in opposition.

Deputy John Halligan

Did the Labour Party not propose a wealth tax and a financial transactions tax?

Deputy Barry Cowen

That is what got it into government for its short stint.

The Tánaiste

If one studies the OECD's examination of our taxation system, one will find that the top 1% of earners in this country, who were mentioned by Deputy Healy, now pay approximately 20% of the income tax. He also referred to the top 5%, who now pay approximately 40% of all the income tax that is paid in this country.

Deputy Joan Collins

That is based on income tax only.

The Tánaiste

The OECD now considers the Irish tax system to be one of the most progressive among the countries it covers.

Deputy John Halligan

How did they accumulate that wealth? They did it on the backs of the poor.

The Tánaiste

I am open to hearing any specific and worthwhile proposals to improve the current position that Deputy Healy might have.

Deputy Dara Calleary

That would be more than the Tánaiste ever proposed when he was in opposition.

Deputy Seamus Healy

We have heard the usual spin and untruths from the Tánaiste. Of course I have made proposals regarding wealth and asset taxes in this Chamber on numerous occasions.

Deputy Finian McGrath

That is right.

Deputy Seamus Healy

I have also done so in my budget submissions. The top 1% in this country, and indeed the top 10% in this country, have a completely disproportionate share of national income. The Government has refused to implement a wealth tax or an assets tax.

Deputy Finian McGrath

Hear, hear.

Deputy Seamus Healy

The Tánaiste is on record as opposing water charges. I would like to quote something he once said.

An Ceann Comhairle

This is not about statements.

Deputy Seamus Healy

He said "the PAYE taxpayer has already paid enough for local services and should not have to pay again".

An Ceann Comhairle

Would you put a supplementary question, please?

Deputy Seamus Healy

In 1994, he said that the Fianna Fáil-Labour Party Government had "imposed Residential Property Tax and now they are making us pay for water".

Deputy Anne Ferris

That was 20 years ago.

Deputy Seamus Healy

When water charges were abolished in 1997, he said the Government of the time was right to do that because they were "a form of double taxation".

Deputy Timmy Dooley

He was not in the Labour Party then.

Deputy Barry Cowen

He could have been in any of three or four parties.

Deputy Dara Calleary

He might have been in New Agenda.

Deputy Barry Cowen

Or Democratic Left.

Deputy Timmy Dooley

That was before he went away and became an altar boy.

Deputy Seamus Healy

The vast majority of people in this country have been fleeced and crucified over recent years. In those circumstances-----

An Ceann Comhairle

Sorry, would you put your question?

Deputy Seamus Healy

-----and in light of the possibility of imposing wealth and assets taxes on very rich people in this country, will the Government withdraw the water charges that are proposed to commence in November of this year?

Deputy Finian McGrath

Hear, hear.

The Tánaiste

Okay. I will comment on the issue of wealth taxes.

Deputy Seamus Healy

Is the Tánaiste accepting that I made a proposal in that regard?

An Ceann Comhairle

The Deputy should listen to Tánaiste's reply, whether he likes it or not.

Deputy Seamus Healy

I am making sure he tells the truth.

The Tánaiste

There are three essential forms of wealth: property, pensions, which account for a large part of wealth these days, and money. This Government has introduced additional taxes in each of those three areas of wealth. We have introduced a property tax.

Deputy Joan Collins

It is a family home tax.

The Tánaiste

We have introduced additional capital taxes. We have introduced an additional tax on pensions that yield over €60,000 a year. We have also introduced additional taxes on money. The idea of coming in here and saying "let's tax wealth" is all very well. It is a grand idea.

Deputy Thomas P. Broughan

We are talking about net wealth.

The Tánaiste

It sounds great and wonderful until-----

Deputy Barry Cowen

Until one gets into government.

The Tánaiste

-----the Government actually comes to do it. The reality is that when the Government comes to do it-----

Deputy Róisín Shortall

It flunks it.

The Tánaiste

-----Deputy Healy opposes it every time.

Deputy Róisín Shortall

It does not have the bottle for it.

Deputy Thomas P. Broughan

The Labour Party's bosses in Fine Gael say "No".

An Ceann Comhairle

Deputy Broughan, please.

Deputy Patrick O'Donovan

The Deputy had his chance but he did not stay around and stand his ground for long enough.

An Ceann Comhairle

We are over time. If Deputies do not want to hear the Tánaiste's reply, I will just cut off the debate.

The Tánaiste

On the issue of water, the Government has decided-----

Deputy Billy Kelleher

To make the ordinary people pay.

The Tánaiste

-----to make sustainable provision for water services in this country for probably the next quarter of a century or more. That is a prudent thing to do.

Deputy Seamus Healy

The Government has decided to fleece families.

Deputy Joan Collins

People will have to pay for dirty water.

The Tánaiste

The previous Government failed to do that. We made it clear in the programme for Government that a charging arrangement based on a metered system, with a free water allowance for households, would be introduced.

Deputy Seamus Healy

I thought we had free water now.

The Tánaiste

We said that charging for water would take place on a metered basis beyond that free allowance.

Deputy John Halligan

We have not even been told what that allowance will be.

The Tánaiste

Rather than exaggerating and telling people that this cost will be very excessive-----

Deputy Michael Healy-Rae

The Government told lies about the property tax.

The Tánaiste

-----Deputies should be assured that the Government is on the side of families and households on this issue.

Deputy Billy Kelleher

The Tánaiste opposed water charges three years ago.

Deputy Barry Cowen

He certainly opposed them when he was in the Workers Party, Democratic Left and New Agenda.