Limerick East): The implementation of the Voluntary Health Insurance (Amendment) Bill, 1995, is intended to legislatively better equip the VHI for competition arising from the completion of the EU's Internal Market in non-life insurance, which includes private health insurance.
The EU's Third Non-Life Insurance Directive has provided the impetus for change in the way such insurance business is conducted in the EU as a whole. Relative to other member states, the potential change in Ireland may be regarded as even more significant because our private health insurance market has developed without the presence of competition. The directive has taken a very simple and effective path to the creation of the Single Market by providing that an undertaking authorised in one member state can, on the basis of that one authorisation, sell insurance in any other member state either on an establishment basis or by way of freedom to provide services. The directive provides necessary safeguards, with regard to prudential and other matters, to ensure proper supervision of the business in the interests of policyholders.
Most importantly in Ireland's case, the directive allowed for the adoption and maintenance by member states, in certain circumstances and to protect the general good, of specific legal provisions in so far as these do not unduly restrict the right of establishment or the freedom to provide services by authorised undertakings. The Health Insurance Act, 1994, was enacted to implement the directive here as regards the private health insurance aspect of non-life insurance. This Act sets down the regulatory framework within which the private health insurance business will operate and develop. It gave the force of law to the principles which have characterised our system and served our people so well over the years.
The Act provides that an undertaking pursuing health insurance business here must provide cover on a community rated basis and must adhere to the principles of open enrolment and lifetime cover. The Act, therefore, ensured that the Irish public will continue to benefit from the strengths inherent in our system which have been applied with great effect for the common good over almost 40 years. These guiding principles have kept private health insurance within the reach of the ordinary person and particularly those who would be vulnerable to being priced out of a high risk system.
Such a system is the opposite to community rating as under it premium levels are determined by reference to the individual risk being undertaken and considerations such as sex, age and health status are determining factors. Risk rating does not favour the elderly and chronically ill. I am fully committed to preserving our equitable and effective system of community rating in the interests of all our people.
I consider the entry of competition into the private health insurance market here to be both desirable and necessary. I am anxious to see this occur as I believe it will invigorate and develop the business of health insurance particularly in terms of marketing, design and choice of products. It will provide the dynamic for improvement and the continued achievement of high standards in the provision of services to the public. It should be borne in mind, however, that the opening of the market will not necessarily lead to lower premiums as there is a problem in markets generally with increasing medical costs being faced by Governments and insurance companies. At least initially, the most strenuous competition between undertakings may be in relation to services and products rather than prices.
There are companies which are interested in entering the Irish market. Understandably, before deciding on the matter, these are awaiting completion of the health insurance regulatory framework in the form of regulations under the Health Insurance Act. I expect to be in a position to sign these extensive regulations very soon. The implementation of the provisions of this Bill will mean that the VHI, with its specific knowledge and long experience of the Irish market, should be better placed to meet the challenge of competition.
The Voluntary Health Insurance Board was established and currently operates under the Voluntary Health Insurance Act, 1957. While the VHI's business has progressed along with the social and economic context within which it has traded over the almost 40 years since its establishment, no parallel or complementary progression has been effected in terms of the legislation under which it operates. The 1957 Act has seen the VHI develop in a way that reflected the highly sheltered nature of its market. Nevertheless, its contribution has been one of solid service as regards fulfilling a public need for the provision of an extensive protection to its members against the cost of hospitalisation for serious injury or illness. Even when one allows for the specific market conditions prevailing in the past, it remains a great feat that the VHI's membership has increased up to the point where it covers over one-third of our population.
The VHI has done the country a valuable and enduring service in pioneering the concept of private medical insurance with such great effect among our people. While many changes and challenges have gone before, the creation of the open market and the advent of competition is perhaps the most crucial one the organisation has ever faced. In order to succeed in the new environment, the VHI will have to develop and vigorously maintain those characteristics which define a successful commercial undertaking, such as a strong marketing focus, dynamic product development and adaptability to change.
Anyone who keeps in touch with developments, internationally, in the health insurance area will appreciate the great extent and pace of change it is undergoing as companies vie to increase or protect market share. The VHI must shift radically from an organisation which was developed in a highly stable environment to one of leadership in a highly competitive market. The Bill now before the House for consideration represents a key move towards modernising the VHI. It will strengthen the position of the VHI in a number of major respects, which I will refer to again in this opening statement.
By reference to the principles underlying the Bill, it is worthwhile to briefly consider the origins of the VHI and its development to date. Its establishment was recommended by the advisory body on the voluntary health insurance scheme which reported to the Minister for Health in 1956. The key objective set for it was to provide insurance against the cost of major and unforeseeable medical costs in circumstances where a large percentage of the population was not eligible for public health services.
The VHI was established under the umbrella of the State as a not-for-profit body because at the time the private sector appeared unwilling or unable to operate a scheme of voluntary health insurance. The 1957 Act provided that anyone willing to engage in the business of making available private health insurance in the State had to obtain a licence from the Minister for Health and the operation of this provision over the years saw the VHI develop as the provider of private health insurance to the general public. The growth of the VHI has been such that its membership now comprises 1.3 million people, or 35 per cent of the country's population.
The VHI is among the largest insurance operations in the Irish market. The change in the scale of its business can be readily appreciated when one considers that in 1980 it had a subscription income of £25.2 million and claims of £19.6 million and that the corresponding figures for 1995 were £232.6 million and £233.1 million. Both in terms of cost and complexity, the business of making available schemes of voluntary health insurance has moved a long way forward since the time 40 years ago when the advisory body recommended establishment of the VHI.
In the 1980s the VHI experienced considerable cost pressures due to factors such as high outpatient claims, rapidly rising in-patient hospital charges, increased claims payments due to steeply rising volumes, major new facilities coming on stream and declining investment income. The culmination of this very difficult financial period was the incurring of operating deficits of between £11 million and £12 million in 1988-89. These posed such a threat to the very existence of the organisation that the implementation of a tough programme of financial recovery became necessary. This was successful in arresting the adverse trend in the organisation's finances but gave rise to the reduction of benefits available to members and increases in premiums, in addition to other cost containing measures.
Although the VHI is not in so precarious a financial position as it was at the end of the 1980s, it must strive towards significant improvement, especially regarding its reserves. While the board recorded a small operational surplus in its accounts for the year ended February 1995, the continuing underlying trading position gives cause for some concern. Along with health insures generally, cost containment is a perennial problem for the VHI.
Excluding high out-patient claims, which were controlled by reducing benefits in that area, the factors previously mentioned which drive cost increases are still very much in evidence. In addition to this, members of the VHI have a heightened expectation of ready access to sophisticated health care services and facilities. There is also an unfavourable demographic trend as regards the ageing profile of VHI members, which generates greater demands for health services and consequently leads to greater outgoings.
There is a wider picture relating to the development of our health services within which the contribution of the VHI over many years may be regarded. It has played a very significant role in the development of our health services through its schemes of voluntary health insurance. These have served to help maintain the public/private mix which has been fundamental to the growth in health service provision. Ireland has benefited from an overall system which has provided a vigorous private sector. An environment has been developed whereby consultants provide service on the public hospital site not only for their own private patients but also for public patients. Both the public and the private sector benefits from the mix, allowing for greater co-operation and collaboration in the provision of the best possible service to patients.
The considerable degree of interdependence which exists between those involved in the delivery of health services represents fertile ground on which to improve relationships and develop consensus. The strategy document on effective healthcare in the 1990s recognised the potential which exists to foster understanding between the healthcare sectors through the exchange of information, the co-ordination of approaches and the maintenance of uniform standards.
The healthcare consultative forum was identified as the vehicle through which better communication and a sharing of understanding could be pursued as the basis for practical co-operation. I will be making arrangements soon to establish the forum as I believe it holds the potential to positively influence the approaches to the future delivery of our health services. I am anxious that all means be explored to stimulate constructive discussion directed at achieving the prize of a shared vision of the future shape of our healthcare services for the good of all of our people. The VHI has a significant contribution to make to this process.
Globally, health insurance is an evolving business where a ready capacity to adapt to change and to seize opportunities is a prerequisite to success and survival. In this context, and especially by reference to our membership of a wider European economic community, it was always in prospect that the VHI was going to face a period of significant change. In 1994 the then Minister for Health, Deputy Brendan Howlin, established the VHI review group to report to him on the strategic and operational capacity of the VHI in the context of the Single Market. The group considered that there was a need for radical change in the VHI's business culture and approach.
The review group viewed the appointment of a chief executive, who could provide leadership and who would be allowed the freedom to transform the organisation and its business culture to one of innovation, imagination and customer responsiveness, as central to effecting vital change within the organisation. It laid emphasis on the fact that it regarded the appointment of a chief executive with the requisite experience and qualities as pivotal to the entire thrust of what it considered should be done to move the VHI forward in terms of the new market environment facing it.
Mr. Brian Duncan, formerly of Irish Life plc, was appointed chief executive of the VHI in February of last year. There has also been wider managerial change in the VHI with the restructuring of its top level management through the recent filling of four new director posts — sales and marketing, operations, finance and business development. These practical steps demonstrate the drive which is underway to heighten the business orientation of the VHI in a changed trading environment.
It was also the view of the review group that the board of the VHI be enlarged in order that it would comprise skills and experience commensurate with those of a modern major commercial insurance undertaking. Provision to enable this to be done is being made in the Bill. I am not, however, at this stage addressing in the Bill the review group's recommendation about changing the corporate status of the VHI to that of a limited company with a 100 per cent State shareholding. At a later point in this statement, I will inform the House of my position regarding this matter and my reasons for not embarking on a conversion of corporate status at this particular time.
Undoubtedly, both in terms of its size of membership and annual financial outlay, the VHI is a major stakeholder in our health care system. The schemes of voluntary health insurance it has operated over the years have served to support the essential balance between public and private medicine which is at the very core of access to and quality of health care in our closely integrated system. Therefore, it is not unusual that the Minister has maintained a broad practical interest in the strategies and policies devised by the VHI. On top of this the Minister is the 100 per cent shareholder. This relationship carries with it a duty to be satisfied as to the financial wellbeing of the VHI and that it is publicly accountable in the performance of its statutory functions. Consequently, the Minister is involved in such matters as determining membership of the board and ensuring that the business of the VHI is being properly handled, including premium or product changes. The Minister is not involved in operational matters or the board's day-to-day management and commercial decisions. The Minister's relationship with the VHI is very much concerned with the broad thrust of its proposals. It is not my intention that there should be any greater degree of involvement by my Department in the affairs of the VHI than heretofore. One can anticipate that in the not too distant future the influence and impact of the competitive market will be the important consideration in how the VHI conducts its affairs.
Considering the context I have outlined regarding health insurance, it is vital that the VHI becomes a more market driven organisation capable of managing change and adopting to new challenges, including competition. It must also be legislatively equipped to take prudent measures to ensure the most cost effective delivery of its schemes and to control its claims experience. It needs to have a board which can, with a greater range of expertise, more fully act on behalf of subscribers.
The Bill will support the VHI's efforts to more effectively manage costs. It is imperative to the retention of the system of mixed public and private healthcare that private health insurance features strongly in how services are funded. Rising claims costs mean higher premiums, which in turn can force down the numbers able to afford cover. Such an experience would be damaging, if not fatal, to a community rated system which relies on broadly based participation. The Australian community rated health insurance system suffered such an adverse experience which diminished the numbers of lives insured. It also gave rise to a re-examination of the mechanisms designed to support the system of community rating. The regulatory framework being implemented in this country has taken account of the Australian experience.
I move now to the main provisions of the Bill. Section 2 deals with arrangements for providers. This replaces section 4 in the 1957 Act but retains the provision that defines the VHI as a "not for profit" body which has served the Irish people so well.
The new section addresses a significant omission from the provisions of the 1957 Act by giving the board explicit powers in relation to making arrangements with health service providers who make available treatment and care to its members. The 1957 Act was silent on this important aspect of the board's operations. Accordingly, it is proposed to bridge a gap which has existed in its legal capacity as regards arrangements with service providers and to set down clearly what the powers of the board are in that regard.
What is intended is that the VHI should be put on a footing corresponding to that of commercial undertakings generally in the conduct of its business arrangements with providers. The VHI must have such powers as otherwise it will have no basis in law on which to take prudent measures to contain costs through ensuring the delivery of quality services on the most economical basis.
It is in the interests of the members of the VHI that it can manage costs as failure to do so could quickly lead to premium levels escalating beyond the reach of most. Health insures worldwide are constantly struggling with this difficulty and it would be unacceptable to expect the VHI to operate in a vacuum where the issue is one that could jeopardise its very survival. Clearly, the provider and insurer have a shared interest in the optimum provision of services to the member/patient. In this context there is no reason why providers and insurance companies would not be prepared to be transparent and accountable about the services they provide. Providers and insurers also have a shared crucial interest in the maintenance of a high participation rate in voluntary health insurance schemes and the continued existence of a strong ethic and culture of private health insurance among the population. In its 1994-95 financial year, the VHI paid out £107 million to private hospitals and £60.3 million in respect of consultants' fees. The amount paid out to public hospitals in the year was £57.2 million. Therefore, the total payout to hospitals and in respect of consultants' fees was £224.5 million. Developments in other countries show an acceptance on the part of providers and insurers to work together in taking new approaches to how care and treatment are delivered. Such moves recognise the importance of seeing the wider picture of interdependence which underlies the private health insurance system and failure to do so will not serve the public and will ultimately not serve any party.
There were two amendments of a substantive nature which were brought forward by me in relation to this section in the Bill's passage through the Dáil. One of these allowed that, in addition to the matters already specified under the section as published, the VHI may have regard to the wider perspective relating to services, either existing or proposed, when considering whether to enter into an agreement with a provider. This is no more than one would expect of an undertaking applying normal and sound business principles in its decision making process.
Section 2 also makes provision for the VHI to undertake schemes of health-related insurance which will give it wider flexibility for innovation in the product design area. Traditionally, the VHI has provided schemes which specifically indemnify the member, in whole or in part, against actual medical costs incurred in the treatment of injury, disease or illness. The success of the VHI in terms of its market penetration of 35 per cent of the population, as against 12 per cent approximately of those with private medical insurance in the United Kingdom, can be partly attributed to the medical indemnity product it provides. This is indicative of the sense of security and reassurance it offers the insured person against the uncertainties of serious illness and injury. While this will remain the VHI's core business, it needs to have the capacity to compete against companies which are offering forms of cash based insurance such as hospital cash. It also needs to be given the capacity to be creative in a market that demands innovation. It needs to be able to compete on a diversity of products — for instance, those intended to appeal to specific groups or "add on" cash products to enhance the attractiveness of existing schemes or preventive or "wellness" schemes.
The Bill will enable the VHI to develop diverse packages of insurance in the form of a combination of indemnity and cash cover, thereby putting it in a position to be more responsive to the needs of its members and the market generally. A key target constituency for new products should be young people and the VHI will be able to tailor packages to attract them into private health insurance. Their participation is vital to the maintenance of a strong community rated system. The Bill provides that schemes of health insurance shall be subject to the consent of the Minister. Therefore, I consider it opportune for me to state that while indemnity insurance will remain the main business of the VHI, I am disposed towards supporting it in developing attractive and imaginative products aimed at enhancing its membership and revenue situation.
The other substantive amendment under this section which was proposed to me and accepted in the Dáil involved elaboration of the definition given to "health-related insurance scheme". Looking at what is happening elsewhere and taking account of the views of the VHI board in the matter, the provision was defined in a considerably greater degree of detail than was originally the case. The result was to give the VHI a wide variety of options for the formulation of packages, whether benefits are based on indemnity or cash or a mixture of both, or are funded and delivered on a capitation or other programmed basis. There was also provision included for the VHI to make cover available in respect of services in the nature of preventive healthcare or "wellness schemes". This is an area where some foreign health insurers have developed niche products. The intention behind the Bill is to enable the VHI to conduct its business on more commercial lines. That having been said, the dimension which concerns my position as Minister with a 100 per cent shareholding in the VHI is to be recognised. I am accountable to the Oireachtas in that regard and it is therefore legitimate for me to have an input into the policy and strategic considerations of the VHI in order to satisfy myself as to the appropriateness and soundness of any particular direction being taken.
Section 3 of the Bill puts on a formal footing the practice which has operated until now whereby the VHI consulted the Minister in regard to proposed premium increases. The section now places a duty of notification on the board; it provides that the board can apply increases automatically after a specified short period has elapsed unless the Minister expressly issues a reasoned direction against implementation of the increases. It is entirely appropriate that the Minister should have the capacity to have some real input in relation to premium increases which can impact on 1.3 million of our population. The fact that the VHI has a near monopoly in the market means that it is in order for the Minister to reserve the power to intervene should circumstances warrant. The VHI review group considered it appropriate for premium levels to be subject to regulatory approval for so long as the VHI continues to enjoy a virtual monopoly of the health insurance market. The response by the Minister to notification of proposed premium increases under the section will be prompt. In effect, this section brings clarity and structure to an informal arrangement that has been based more on custom and practice in the past.
An amendment to this section was considered by the Dáil Select Committee on Social Affairs also. It proposed that the Minister's power to issue a direction to VHI not to implement a premium increase be exercised by regulation. I viewed this as making the process more complicated and protracted than it needed to be. The amendment was withdrawn following discussion.
Section 4 recognises that the limitation on the board's size, of not more than five members, imposed under the 1957 Act has outlived its relevance in terms of the contemporary needs of a national commercial undertaking. This was adequate to meet the needs of a board which was presiding over a State monopoly in a stable and uncomplicated market environment. As the trading environment has become more demanding, complex and volatile over time, and especially in view of the opening of the market to competition, the board must change with the times and circumstances. Section 4 of the Bill provides for the size of the board to be extended to not more than 12 members. It will therefore be possible for me, as Minister, to ensure there is available at board level the depth and range of knowledge and experience appropriate to the modern VHI. It is my intention that the board's composition should reflect the level of skills and expertise appropriate to that of a major commercial insurance undertaking. It is also, in my view, desirable that it should have an effective consumer input.
In order to avoid having to enact a further amendment, should future circumstances have warranted the size of the board to be increased beyond 12 members, the Bill as originally published had provided for the Minister to determine the number of members by regulation. However, having taken account of opposition to this provision as expressed to me in the Dáil Select Committee on Social Affairs, it was deleted on my amendment on Report Stage.
Section 4 also provides that the number of board members who are health service providers is not to exceed two persons. Subject to the provisions of the law, it is the prerogative of the Minister to select board members. While the VHI is about the business of healthcare, it is first and foremost an insurance undertaking. The skills and expertise it needs to thrive are those relevant to the insurance sector generally — actuarial, financial and marketing — as well as expertise in the healthcare industry. Against this background, I am satisfied that the law should place an acceptable upper limit on the number of board members who come from a provider background. I want to make it clear at this point that those from a provider background, employer or medical, who have served on the board have done so always with the best interests of VHI members and subscribers central to their contributions and actions. It is not in question that a person's health service expertise and specific knowledge of the area enables him or her to make a valid and positive contribution to the work of the board. The issue is rather one of the appropriate balance to be struck in providing the VHI with the composition of skills and expertise at board level which will best serve the organisation's needs. I consider that not more than two persons who are health service providers out of not more than 12 members overall represents an appropriate balance.
An amendment proposing deletion of the subsection which limits the number of health service providers on the board was the subject of considerable debate in the Dáil but was not acceptable to me. I believe that over time, and unintentionally, a drift towards a dominance of or disproportionate participation by health service providers on the board could occur. It is right that the Bill should contain checks and balances to ensure that such a situation cannot develop while at the same time allowing for the board to benefit from the particular knowledge and expertise which providers have to offer.
It is appropriate at this point to place on the record of the House the debt of gratitude which is owed to board members, past and present, who have worked so selflessly for the betterment of the organisation and in the interests of its members. Their contribution is one of distinction and honour in giving generously of their time and energy for the public good. One must also recognise the very great and effective input which the members of staff of the VHI make to the organisation on an ongoing basis. Their industriousness, commitment and dedication is certainly one of the strong cards the VHI holds in whatever competitive battles may lie ahead. It is a great credit to the organisation that at 6 per cent of premium income the VHI's administrative costs stand very favourably in comparison to those of other like companies.
Section 5 gives a statutory basis to the position of the chief executive of the VHI and in so doing underlines the crucial leadership role attaching to the position, which the VHI review group regarded as vital to effecting change in the organisation. As I have said, the group identified the chief executive as a key agent of change and set out principles under which the chief executive should have total responsibility for the efficient direction of all operations. The Bill provides that the chief executive, under the authority of the board, will be the person responsible for carrying on, managing and controlling generally the administration and business of the VHI. The Bill puts the chief executive on a par with counterparts in other commercial State bodies in terms of carrying through the task of effecting and managing change for the good of the organisation.
Section 6 relates to the conditions which will apply where a board member or a member of VHI staff is nominated or elected to membership of either House of the Oireachtas or of the European Parliament. It supersedes section 9 of the 1957 Act, which dealt with Oireachtas membership only.
Section 7 relates to the terms and conditions of service of members of staff of the VHI. It obliges the board to have regard to prevailing Government policy or nationally agreed guidelines in determining the remuneration or allowances to be paid to staff. This is now a standard provision in legislation of such bodies. An amendment to delete that part of the section requiring that the board comply with any directives from the Minister, given with the consent of the Minister for Finance, regarding the remuneration, allowances, terms and conditions for staff was withdrawn after consideration by the Dáil Select Committee on Social Affairs.
Section 8 provides for a prohibition on the unauthorised disclosure of information. This recognises the sensitive nature of the information which the VHI holds. It prohibits the disclosure of confidential information unless duly authorised by the board. It does not therefore impinge on the freedom of staff to give information, as required in the normal exercise of their duties, in reply to inquiries received. The provision reflects the need to protect commercially important information in a new and competitive market environment. The prohibition applies not only to board members and the staff of VHI, but also to those who act as consultants and advisers to the organisation. The description of confidential information as provided under the section was made clearer by an amendment which I brought forward in the Dáil Select Committee on Social Affairs and which was accepted by it.
Section 9, which replaces section 21 of the 1957 Act, enhances the accountability of the board to the Minister by reference to the information which it is obliged to furnish at his or her request. It does not, however, require the board to make available information about an individual member of the VHI or a particular health service provider. A small change to this section was made on my proposal to the Dáil Select Committee on Social Affairs to avoid any doubt that the Minister's entitlement to receive information is superior to the provision relating to the prohibition on the unauthorised disclosure of confidential information contained in section 8.
This is the first piece of legislation prepared in relation to the VHI since its foundation. It is intended to effect essential amendments to the 1957 Act and is a significant step on the path to transforming the VHI to enable it to meet new market challenges.
I said earlier that I would give the House my reasons for not making provision under the Bill to change the VHI's corporate status. I now return to this point. I have an open mind on this matter and I am prepared, in due course, to recommend to the Government what is best for the organisation. I have set out the considerable change which the VHI is undergoing at present. This is consistent with the approach recommended by the VHI review group who, first and foremost, advocated a change in the business nature, culture and orientation of the VHI and identified the chief executive as the catalyst for this. The group was of the view that the appropriate corporate structure for the VHI in the future would be that of a limited liability company with 100 per cent of the shares held by the Minister. It considered the conversion to a limited company to be part of a process of radical change to encourage the development of a more innovative and commercial approach.
I am satisfied that a change in the corporate status of the VHI, while it would remain 100 per cent State-owned, should be further explored. I am of the opinion that this would be most appropriately and effectively undertaken when the proposed new arrangements to enhance the expertise of the VHI at board level have been effected. The recent restructuring of top level management should serve to assist the enlarged board in this process. I will be requesting that the enlarged board give detailed consideration to the matter of a change in corporate status and that it submit to me such developed proposals as it may deem appropriate in this regard. Accordingly, this is a matter in respect of which the House may be asked to consider legislation at a future date.
Other significant amendments were proposed in the Dáil which are not provided for in the Bill before us and regarding which I would like to inform the House. An amendment was tabled at the Dáil Select Committee on Social Affairs to the effect that nothing in the Competition Act, 1991, would prevent or restrict the VHI, or any health insurer, from exercising the powers or doing any of the things provided for under section 2 of the Bill. The issue of exempting health insurers from the terms of the Competition Act, 1991, was discussed at length by the committee and the amendment was withdrawn as a result.
The Dáil also considered an amendment relating to the establishment of a VHI users' commission which I considered, openly and carefully. However, having fully reflected on the matter, I formed the view that a statutory body dealing primarily with complaints of VHI members would largely be a duplication of the independent and effective arrangements already at the disposal of VHI members through the Insurance Ombudsman. It was also my opinion that to take such a step now would fail to give a reasonable opportunity to the members' advisory council, recently established by the VHI, to operate and have an impact as regards the broader considerations of promoting and enhancing customer services.
I consider that the Voluntary Health Insurance (Amendment) Bill, 1995, contains a balanced and measured set of provisions. I recommend it to the House as a significant step in the process of modernising this State commercial enterprise which has a business relationship with and service obligation to such a large proportion of our population. I am confident that, along with the personnel and structural changes within the organisation, the Bill will enable the VHI to adjust to and take best advantage of a changed market environment. I am working towards a VHI that is financially strong; adaptable and market driven; dynamic and innovative in the area of product development; having good working relationships with providers and a good customer relations base.
The objective of this Bill is to make the VHI a more vibrant commercial undertaking which is appropriately resourced, in terms of its governing legislation, for the era of competition ahead. I believe that this Bill puts the VHI on the right course to maintain its position as the main force in private health insurance in Ireland for the future. I commend the Bill to the House.
