When progress was reported last night, I was referring to the proposals mentioned by Deputy T.F. O'Higgins for financing general medical services by insurance. I have since looked at reports of earlier references by the Deputy and I am clear now in my mind as to their scope. Only a small fraction of health expenditure, as a whole, would, it seems, be met by insurance contributions under the proposals and these contributions would be additional to the rates and taxes by which most of the costs would be met. I may be wrong, but there seemed to me to be a conflict between what Deputy Declan Costello said on this point and what Deputy T.F. O'Higgins has said on it. Deputy Costello seemed to envisage insurance contributions meeting the cost of free hospital services.
The House will be aware that the Government are not convinced that insurance contributions would be a desirable means to finance health services and there seem to me to be obvious difficulties, for example, in the application of an insurance scheme to farmers and self-employed people. However, in my general review, all ways of financing services must be looked at. I will, therefore, go very fully into the pros and cons of every idea for financing health services which has been suggested in recent years, as, indeed, I will for all constructive proposals for improvements in the services. As I told Deputy Corish last night, when I eventually come along here with proposals, they will not necessarily be cut and dried. There will be a certain amount of elasticity attached to them and if constructive suggestions come from all parts of the House, I am quite prepared to incorporate them in the final scheme or plan.
Many such ideas and a number of criticisms of the present services were put forward in yesterday's debate. I do not wish to detain the House by referring to each of these today as most of them relate to points which are being considered in my general review but what was said has been very carefully noted in my Department. I think there will be general agreement that an expression of my views on these points would be premature at this stage.
I would not like the House to infer from what I have said that I would acquiesce in a point of view that would decry the present services as being out of date and insufficient. Much progress has been achieved up to now by successive Fianna Fáil Governments. There was criticism last night that such was not the case. The Health Acts of 1947 and 1953 made many improvements possible and under these and several other Acts, there has been much progress. This is evidenced by the fact that the health expenditure for this year is expected to be over five times what it was in 1947-48.
