Dáil Éireann díospóireacht -
Wednesday, 24 Oct 2012

Vol. 773 No. 19

Topical Issue Debate

Student Grant Scheme Applications

Deputy John O'Mahony

I thank the Ceann Comhairle for selecting this matter and for allowing me raise it. August and September are life-changing months for second level students who are moving on to third level. They get their leaving certificate results in August and get their college offers later that month or in early September. They then have to go and look for accommodation and people with whom to share it. It is a traumatic time not just for the students, but for their parents. The big issue for them at this time is the application for a grant. This has been a major issue over the years. As elected representatives, we all know there have been difficulties over the year, from the time there were 66 different bodies awarding grants. The good point with regard to so many bodies being involved was that the issue was local and personal.

I welcome and support the many innovative ideas the Minister for Education and Skills has introduced since he took up his position and am not raising this issue to knock him or anything else. The SUSI concept and the centralisation of the awarding of grants is good if it works smoothly. I welcomed it when announced and still have no problem with it. However, the concern I had and still have is that there may be issues such as those we had when the medical card application system was centralised. In other words, I am concerned about the bottlenecks that occur in the system, the way the process becomes impersonal, documents being lost and the resulting delays in dealing with applications. The Minister facilitated a briefing from SUSI earlier in the year and in its presentation the system looked wonderful and it seemed every angle was covered.

I raise this issue to be helpful rather than to knock the system, because there are teething problems. This year I have received more queries in September and October on the issue of grants than in the past number of years. These concern the delay in processing grant applications and in hearing appeals. I welcome the e-mail service provided for public representatives by SUSI. However, the problem is that the answers returned, which are delivered promptly, do not provide any information whatsoever. If they do not give us information, they do not give students information. If the system was working well, we would not be getting people raising this issue in our offices or at our clinics, but it is not working well.

Let me give an example of the response I received last week, which is what prompted me to raise this issue. The response stated: "Documents have been received in support of this application and they are currently awaiting review." This is just a one-line answer that gives no indication whether the application will be considered in the next two or three weeks or whenever.

I want to justify what I am doing by saying I received two answers this morning, within eight minutes of each other, after this was submitted. The first of them gave me an answer and the second gave me an advanced answer. Maybe the fact that I raised it helped me in some way to get those answers. I acknowledge that. Ideally, it would be better if applications were made sooner. I know of a student who was not offered a college place until the middle of September. In other words, he got it on the third award. It is impossible to submit one's application early if one does not have a college place. What is the view at a more global level of the experience to date? Will new things be put in place next year? Could a tracking system like that used in the passport service be used to allow students to track their applications without clogging up the system with queries to which they should be able to get easy answers?

Minister of State at the Department of the Environment, Community and Local Government (Deputy Jan O'Sullivan)

I thank Deputy O'Mahony for raising this issue. I am taking this Topical Issue on behalf of my colleague, the Minister, Deputy Quinn. As the Deputy said, the processing of student grants for new entrants has been centralised this year under one body - Student Universal Support Ireland, or SUSI, which was established as a unit of the City of Dublin VEC. This will replace the 66 grant-awarding bodies which were previously responsible for student grants. Local authorities and VECs are continuing to deal with renewal students until they complete their existing courses. Some 65,000 applications have been received by SUSI this year, of which approximately 35,000 are expected to succeed. SUSI is aiming to award all successful applicants before the end of December. The Deputy will recall that in the past, many students did not receive payments until much later in the academic year.

Some 65,000 applications were received this year. Approximately 5,000 late applications are awaiting initial assessment. Almost 10,000 applications have been refused, or have been cancelled by the applicants. In over 16,000 cases, no response has been received from the students to requests for supporting documentation. Text reminders have been sent to these applicants in a further effort to get the documentation submitted. Almost 20,000 sets of documents are awaiting validation. It should be noted that in 17,500 of these cases, incorrect or incomplete documentation has been submitted at least once. These documents are awaiting validation for at least the second time. The remaining applications have been assessed by SUSI. More than 4,000 have been awarded, more than 2,000 have been provisionally awarded pending submission of course acceptance forms, approximately 4,500 are being reviewed by SUSI and a further 4,000 have had additional information requested from the students involved.

It is inevitable that a late rush of applications will cause some delays in a student grant processing system. The Department is continuing to monitor the situation actively in close consultation with SUSI, which is working with the Union of Students in Ireland to encourage students to submit outstanding documentation. SUSI is constantly seeking to improve the information available online and from its helpdesk, e-mail and telephone services. SUSI has received 1,019 appeals to date. While SUSI aims to issue determinations as promptly as possible and within the specified 30-day timeframe, I am aware that a number of appeals on hand were received more than 30 days ago. The Department has been assured by SUSI that these cases are being given priority and will be dealt with in the next five days.

The main aim of putting in place a single agency was to improve substantially the grant application experience for new applicants each year. It was inevitable that there would be process challenges in its first year of operation, particularly when the new system was delivered in an extraordinarily short timeframe. In these circumstances, it is particularly important for the system to respond in a prompt and effective manner to any challenges that arise. I assure the Deputy that the Department is continuing to monitor progress closely and is actively engaged with SUSI to ensure every possible action is being taken to expedite decisions on all outstanding cases. The Minister, Deputy Quinn, contacted the CEO of City of Dublin VEC in relation to this matter this week. The CEO assured him that any delays arising in the operation of the new system are being addressed by SUSI as a matter of priority. The utmost importance is being placed on communicating with applicants to ensure all outstanding documentation is submitted so that decisions can issue to students and any appeals arising can be dealt.with expeditiously.

Deputy John O'Mahony

I thank the Minister of State for her reply. I asked whether something could be done differently. I accept in good faith the efforts that are being made to fine-tune this system. One of the letters I received referred to "the company" that is validating the documents that are submitted. Can the Minister of State let me know whether some of the processing of grant applications, or of appeals relating to grant applications, has been outsourced to an outside body? Given that almost 20,000 applications have been accompanied by incorrect information-----

Deputy Jan O'Sullivan

The correct figure is 17,500.

Deputy John O'Mahony

-----can something be done to educate people on how to make applications? It might help to ensure SUSI does not receive applications that are half-completed or do not include the full documentation. If almost 20,000 applications are incomplete, something is wrong. I understand that appeals should take no more than 27 days. Anecdotally, I have heard about a few dozen appeals that have taken between 30 and 40 days. If there was no issue in this regard, I would not be raising this matter. I acknowledge the efforts that are being made to fine-tune the process and ensure it will be a good system. I hope that the bottlenecks in August and September of this year will not be repeated in the future and that this problem will be solved.

Deputy Jan O'Sullivan

As it is a totally new system, it is understandable that there have been some difficulties. I know SUSI is trying to deal with them as expeditiously as possible. I accept that the number of incorrect application forms - 17,500 - seems to be quite large. It is surprising that so many people failed to give all the information or fill the forms in correctly. I understand the Union of Students in Ireland is working with students to encourage them to supply all the documentation. A helpdesk and an inquiry line are available to assist students who might be having difficulty understanding what they need to submit. I am not aware that responsibility for the validation stage has been passed to an outside body. I can get that information for the Deputy. He suggested that a tracking system similar to that used for passport applications should be used. I can pass that suggestion on to the Minister. The move from 66 bodies to a single body for these purposes is a big undertaking. Like other Deputies, I know from my experience that there were delays in the old system when one had to deal with one's local council or VEC. It is a big undertaking. Every effort is being made. SUSI has acknowledged that some appeals have gone beyond 30 days even though that should not happen. I made that point in my opening statement as well. SUSI is doing everything it can to bring it down to a minimum. We all understand it is difficult for students and families to await the making of a decision or the payment of a grant. Every effort is being made to limit the waiting times.

Social and Affordable Housing Eligibility

Deputy Martin Heydon

I am thankful for the opportunity to raise this issue in the House. I am glad the Minister of State is present to respond to what I have to say. I have become increasingly aware of this difficulty in the last 18 months, since I was elected to the Dáil. It has been raised with me by individuals in my local area on many occasions. If that experience is replicated throughout the country, it is a big problem that needs to be addressed. As the Minister of State is aware, if one is to qualify for local authority housing and get one's name onto the local authority housing list, one must be deemed to have a housing need. If one is to qualify for the payment of rent supplement, one needs to be on the housing list or be able to prove one has been living in private rented accommodation for six of the past 12 months. If one's name is already listed on the deeds of another house, one will not qualify for inclusion on a local authority housing list. Although this condition generally makes absolute sense, we need to consider the circumstances of couples that have recently separated. That is the point I am raising. The impact of separation on a family unit is huge.

It is big enough, given the trauma involved for both partners and the children when they reach the stage where they realise they need to go their separate ways, for whatever reason. The lack of a place to live is extremely stressful and an added difficulty.

The recently published census results for 2011 record the number of separated persons at 116,194, up marginally from the corresponding figure for 2006. Unfortunately, a number of separated persons, some with children, whom I have met are not finding it possible to source housing owing to their names remaining on the deeds of a home in which they can no longer live because their ex-partner is living there. One of the cases of which I am aware involves an individual who bought a property with his then wife. He has recently separated from her and she has remained living in the family home with their children. He had some underlying health issues and depression was a problem. He has done his best by his family by moving out and trying to deal with his own specific circumstances. The couple have separated amicably, but he has no options and nowhere to go. He is sleeping on the couch of an extended family member. This is because his name is attached to the deeds of the property and he is deemed not to have a housing need.

Another factor impacting on this problem is the length of time taken by financial institutions to reach solutions on non-performing loans. I am aware of one case in which a house is due to be repossessed by a bank. The couple have separated. The husband remains in the home, while his wife and their two children are searching for accommodation without success. They are, therefore, literally homeless. Once the bank completes the repossession, both parties will become eligible for housing, but this could take months. In the meantime, the wife and children have nowhere to live. They have approached the community welfare officer for help, but they can only receive an emergency needs payment, a once-off payment which cannot be used as a basis for securing access to any property.

I have spoken to staff in my local authority, Kildare County Council, about some of these cases and, while they are hugely sympathetic, they consider their hands are tied and they have to operate within the rules, rules which do not appear to offer significant discretion for persons who find themselves in the very difficult situations to which I have referred. Often, those most affected are newly separated who have had to move out of the family home, perhaps at short notice or after a lengthy period of difficulty in a relationship. The decision to leave the family home is not an easy one, but sometimes it can be in the best interests of the partner and the children.

I am aware that, once a separation process has been gone through in the courts and forms of legal separation have been agreed, there can be more discretion under the housing system. However, this is of no help in the cases with which I am dealing in which those involved have not yet reached this stage of the process and find themselves with no housing options. I ask the Minister of State to review the regulations in place to see if discretion can be applied in the cases of individuals who find themselves in these very difficult situations. It should be possible to either free up staff in the local authorities to have more directions in these cases in the short term, or else consider integration with the Department of Social Protection in order that community welfare officers will have discretion to deal with these cases as they arise. It is a very big issue and I am glad the Minister of State is here to deal with the topic.

Deputy Jan O'Sullivan

I thank the Deputy for raising this important issue and allowing me to outline the current position. I would like him to know I have commenced a review; therefore, we recognise there is an issue.

The Government's housing policy statement, published in June 2011, serves as a framework for a sequence of legislative and policy initiatives in the short to medium term. Based on a number of fundamental principles and goals that form the foundation of a substantial reform programme, the framework for housing policy responds to current and emerging conditions in the housing sector, taking into account the current economic environment. Central to this approach is maximising delivery of social housing support to those with greatest need within the resources available. In terms of the delivery of social housing, the policy statement clearly identifies that the main focus in terms of supports provided by the Government will be on meeting the most acute needs, namely, the housing support needs of those unable to provide for their accommodation from their own resources.

One of the greatest concerns the Government had was the disparity of procedures across the various housing authorities in accessing social housing support. The 2011 social housing assessment regulations were introduced to provide for a new standard procedure for assessing applicants for social housing in every housing authority. The ultimate aim of the new system is to create a fairer, more consistent and transparent approach to eligibility for social housing support. The regulations providing the legislative basis for the assessment are continually under review in an effort to ensure they achieve that aim.

Regulation 22 of the 2011 regulations addresses the issue of alternative accommodation, with regulation 23 addressing the housing need criteria. It is a matter for each housing authority to assess the need of each applicant household within the terms of the regulations to determine eligibility for social housing support. Paragraph (1) of regulation 22 of the social housing assessment regulations of 2011 provides that a household with alternative accommodation that would meet its housing need is ineligible for social housing support. Paragraph (2) of the regulation effectively ensures paragraph (1) does not operate to exclude from eligibility for social housing support an applicant who owns accommodation occupied by his or her spouse from whom he or she is separated or divorced. The regulation is worded in such a way that once there is a deed of separation in place, this aspect of eligibility for social housing support can be determined. There is no need, therefore, to await judicial separation or divorce to get a decision on eligibility for social housing support in these cases. I consider that this provision is reasonable in most cases. However, I acknowledge the Deputy's point that exceptional cases arise that may not easily be dealt with under the current regulations. As part of the programme of social housing reform which I am advancing, I am reviewing the implementation of the 2011 regulations to ensure they are operating as intended. I will issue revised regulations and guidance, as necessary. As part of the review, my Department will consider what wider discretion might be given to housing authorities to address the difficult and complex cases which may present to them. As I said, I recognise that there is an issue in the case of newly separated persons.

Deputy Martin Heydon

I thank the Minister of State for her detailed response and very much welcome the commencement of the review to which she refers, which makes this Topical Iissue debate timely. She stated, "It is a matter for each housing authority to assess the need of each applicant household within the terms of the regulations," and then sets out the position under paragraphs (1) and (2) of regulation 22. The difficulty arises where a couple are not legally separated or divorced. A deed of separation is an agreement between two parties setting out the terms of the separation, often negotiated through a solicitor. It can be legally binding and includes items such as custody of children, maintenance obligations, ownership of the family home and liability for mortgage payments. However, these issues are not sorted out immediately, whereas the timeframe to which I am referring is the period immediately after the separation when the couple have gone their separate ways and before the deed of separation is prepared. The current regulations do not properly take account of this short period and we need some discretion to allow either the local authority, the community welfare officer or some other party to provide short-term support for those persons who find themselves in this situation.

I am glad the Minister of State referred to current economic conditions, on which I wish to pick up. In some circumstances, couples may have their deed of separation, but, owing to the depressed state of the property market, they cannot sell their property, even though it is on the market. While I hope this will not be a long-term problem, it is a problem for now. Again, flexibility in this regard is needed to get people through this very difficult period. I again thank the Minister of State.

Deputy Jan O'Sullivan

All of us in the Chamber probably know of some of these complex cases. There is a certain amount of discretion under the current regulations and one of the issues I am considering in reviewing the regulations is the position of couples who are separating and genuinely have a housing need that must be addressed. While I do not know exactly how long this will take, I will be doing it as expeditiously as possible.

Hospital Services

Deputy Derek Nolan

I welcome the opportunity to speak about this very important issue. Before I address it, I commend the Minister for Health for the work he has done with regard to the Galway-Roscommon hospital group which is making significant strides in tackling some long outstanding performance issues. The new management team is achieving great results in reducing inpatient waiting lists and times, the emergency department count and trolley figures. It is a tribute to the chief executive officer, Mr. Bill Maher, and the chief operations officer, Mr. Tony Canavan, but also to the co-operation of staff, nurses and doctors who are putting their shoulders to the wheel in delivering improvements, achieving efficiencies and finding new ways of working. They all deserve recognition and credit for their hard work and commitment.

However, while we have seen positive results in some areas of the health service in Galway, it is a harsh reality that waiting times in other areas remain unacceptable. I refer specifically to the urgent need to address the waiting times for the pain clinics in University Hospital Galway and Merlin Park University Hospital. The waiting times in both are totally unacceptable and are causing extreme distress and discomfort to many people who are in dire need of medical attention. I commend the staff who work in the pain clinics in the health service for the helpful and co-operative fashion in which they have dealt with queries from my office. According to statistics I received yesterday, there are now 583 people waiting for an appointment, with the longest wait time being since August 2010.

I have met with many people in Galway who have turned to me for help, completely exasperated with the delays in attending the pain clinics. One constituent who came to me for help and to highlight his plight was a gentleman who was diagnosed with fibromyalgia and who suffers pain in all 18 tender points in his body. His condition has deteriorated in recent years but this year has been his worst to date. Almost every week there are at least three nights where he literally does not sleep and cannot even face going to bed because the pain is so bad. He used to have a photographic memory and was a successful computer programmer. He now suffers from chronic muscle pain in his joints and nerves and regularly experiences memory loss. This man has been waiting since the start of the year to get an appointment at the pain clinic in University Hospital Galway. He was added to the waiting list on the 3 January 2012. Today is the 24 October, almost ten months down the line and he is still waiting. He is still suffering tremendous pain, and he is still fighting to maintain a decent quality of life. Since January he has had one pain free day - one day in ten months that he did not have chronic pain in his joints and nerves.

Other cases have been presented to me of patients with chronic back pain. Another constituent with severe multiple sclerosis was forced to wait months for an injection that would restore mobility, the ability to work from home and dignity to her life. She was once able to receive the injections she so badly needs every eight weeks but now the service has been scaled back. In the meantime she is confined to bed, dependent on her family and unable to function properly.

I am aware of the challenges that face the Department of Health and the Ministers in the Department. The HSE has always suffered administratively and I believe the promised reforms will tackle some of the problems. However, the waiting times for the pain clinic at Galway University Hospital have gone way beyond what is acceptable for a health service. People who are in chronic pain are waiting for an appointment to give them some slight relief from medical conditions which have dominated their lives. I ask the Minister of State to ask the Minister for Health to make a commitment to tackle the problem. It is extremely unfair to expect people who are living with debilitating pain to wait an intolerable length of time to get the treatment and relief they deserve.

Deputy Jan O'Sullivan

I thank Deputy Nolan for raising the issue to which I will respond on behalf of my colleague, the Minister for Health, Deputy James Reilly.

University Hospital Galway has two consultants who provide a pain management clinic in the hospital. These are consultants who specialise in anaesthesia, 50% of whose time is allocated specifically to pain management. Two pain clinic sessions take place each week. In addition, the pain clinic has weekly theatre access for interventional and non-interventional procedures. To support this service, the hospital has provided a resource of three clinical nurse specialists whose time is divided between acute and chronic pain management for both inpatients and those attending the clinics on an outpatient basis. All pain clinic patients can contact the nurses by phone or bleep.

Escalation protocols are also in place to address changes in patient symptoms. If patients are on the outpatient waiting list and their symptoms worsen they can contact their GP who can liaise with the consultants directly. If patients with chronic pain have an acute exacerbation of their symptoms they can attend the emergency department. If existing patients are experiencing any difficulties or worsening symptoms they can contact directly the clinical nurse specialists for pain relief. Patients who have received interventional pain treatment and require a repeat procedure are returned to the waiting list and are prioritised if cancellations occur.

It is regrettable that a small number of patients have encountered delays in receiving appointments for the pain clinic. However, in line with the strict policies introduced by the Department of Health, patients are added to the pain clinic waiting list according to their referral date, and patients are taken off the list according to clinical priority and referral date. Since assuming office, the Minister, Deputy Reilly, has made it clear that priority must be given to taking care of those patients waiting the longest. Once the most urgent cases are treated, hospitals must devote their capacity to treating the longest waiters in a strict chronological order, which is the fairest approach. Progress on waiting lists shows that even with reduced budgets and staffing levels, clear, well informed targets assist hospitals to be effective.

Within the past week there has been a reduction in the overall waiting lists across the country of 16%; in University Hospital Galway itself, access for procedures has improved by 40% since 2011; most notably, considering the difficulties it was encountering in December last year, the hospital achieved the nine month primary targeting list for inpatient waiting lists on 30 September 2012. On behalf of the Minister I thank all the staff involved and acknowledge their dedication and commitment to those significant achievements.

Deputy Derek Nolan

I reiterate my compliments to the staff working in the hospital on the dramatic improvement in many of its services. I regret that the Minister of State, Deputy Jan O'Sullivan, must respond to the issue and that the Minister for Health could not be present to respond because what I raise is extremely important. People to whom I have spoken have rung the pain clinic on a weekly basis. Their doctors have written to the pain clinic asking for speedier referrals and treatment to no avail. I contend that some of the information provided by the Department of Health in the response is slightly inaccurate. It is not something many of those I have met experience. While I appreciate the sentiment of the response, that alone will not solve the problem. The problem is clear. There are two consultants and we need more. There are three clinical nurses and we need more. The reality is that those on the waiting list for the pain clinic in Galway are in pain. They are not waiting for a diagnosis; they are in pain and are seeking treatment for the pain. Each additional week they wait is an extra week in pain. Each additional month they wait is another month in pain. In some circumstances those who are waiting are immobile while others are in agony.

I am not happy with the answer I received. I appreciate that the issue does not relate to the Minister of State's brief. I urge her to speak to the Minister for Health, Deputy Reilly, explain the details of the cases I have raised, in particular the case to which I referred in my initial statement, and ask him to put a specific plan in place, perhaps via a special delivery unit or by agreement with hospital management in the Galway University Hospitals, to deal with the severe delays and frustrations experienced by patients in pain while they wait for pain clinic appointments. In many cases they suffer so much that their lives are debilitated.

Deputy Jan O'Sullivan

Deputy Nolan clearly outlined the difficult position of such patients. I will convey his concerns directly to the Minister, Deputy Reilly. We all want the quickest possible responses to patients in pain or who need care in other ways. The Deputy acknowledged the progress that has been made in various areas. I will convey the issues raised to the Minister and the suggestions Deputy Nolan has made on how to address it, including the special delivery unit. I apologise for not being able to provide a more precise answer as I am not in the Department concerned.

Health Insurance Prices

Deputy Billy Kelleher

I wish to outline the alarming increase in the cost of private health insurance. Many people speak about "middle Ireland" and how hard-pressed it is. An illustration of how serious the situation is for many families is that people are now deciding whether they should fill the oil tank or continue with health cover. We have seen an alarming increase in the cost of premium payments for private health insurance. The cost of VHI cover for a family with two children has increased to €2,300 per year. There has been an alarming increase in recent years. Since 2009, health premia have increased by a minimum of 100% and, in some cases, by as much as 130%.

Year on year there have been exceptional increases.

We have to address this issue. These people are lightening the State's burden in the provision of health care. They have contributed through the general Exchequer in taxation and through sacrifice and effort have taken out private health insurance to provide cover for themselves and their families. They are being crucified. If we allow this to continue, the advances the Government is trying to make in regard to universal health insurance will unravel before the Minister's eyes. People simply cannot afford to continue to pay these alarming increases. Consultants' pay is one issue on which the Government has been faffing about for a long time. There is also the issue of charging private patients for public beds, which has placed and will continue to place a burden on premium holders throughout the country. The €125 million the insurers decided to give upfront in order to dig the Minister for Health out of a hole in regard to his budget deficit is now coming back to haunt us. It is not the health insurers who are paying upfront; rather, it is premium holders throughout the country. That is not good enough.

Deputy Mattie McGrath

I thank the Ceann Comhairle for giving me the opportunity, along with Deputy Kelleher, to raise this issue. Deputy Kelleher has made a pristine case. The last speaker, a Government colleague of the Minister of State, was critical of the answers given to the House by the HSE and the Department of Health. That much was stated clearly on the record of the House. We do not get proper answers or proper governance from the Department of Health. The Minister, Deputy Reilly, should be present today to take these questions and should not send in a Minister of State who does not have responsibility for the matter. I welcome the Minister of State's presence, however, and I wish her well in her post.

This is out of control. I cannot believe the increase in charges, which have gone up by 120% to 130% in the past three years. Increases of 100% have been imposed by the VHI and other organisations. I note that there will be people attending the Joint Committee on Health and Children tomorrow to give answers, but what answers can they give us? It is pure sabotage and hijacking. The Minister has no credibility on this issue because he is one of those who negotiated rates for GPs. He cannot play two sides of the road, although he tries to do so all the time. What will happen is that people will die on the road. More than 2 million people have some kind of cover but this gives them less and less for more and more money. They cannot afford it. Ordinary middle-income families and even the reasonably well-paid cannot afford the cover. This puts pressure on public hospitals, with consequent queues and waiting lists, as was discussed in the previous topic in the debate.

We must change this. We cannot allow the companies to charge these exorbitant rates. I once stayed in a private hospital in Cork and had to travel about 600 yards in an ambulance. Deputy Kelleher would know the place well. I could have walked there but not back, as I was under anaesthetic. The ambulance charge was €600 to bring me less than half a mile - a rip-off. Rip-off Ireland is alive and well and this situation cannot continue. Ordinary people cannot get access to beds or anything else while this rip-off is going on. Consultants are getting too much pay and are using public beds and public equipment to treat their patients privately. The racket has to end. I thought the Minister would do something about this, but I reiterate that he has no credibility with regard to one of the groups concerned. He is not the man to do it. I hope some of his other colleagues will step up to the plate.

Deputy Jan O'Sullivan

I am taking this matter on behalf of my colleague, the Minister for Health, Deputy James Reilly, who unfortunately cannot attend. This issue was around for years during the time of the previous Government and very little was done about it.

There has been recent speculation regarding possible increases in private health insurance premiums. As the Deputies are aware, the Minister for Health has no role to play in the commercial decisions of any health insurer with regard to planned increases in the costs of its insurance products. I am aware that health insurance is becoming harder to afford, particularly for older people, as insurers increasingly tailor their insurance plans towards younger and healthier customers. The Government is strongly committed to protecting community rating, whereby older and less healthy customers pay the same amount for the same cover as younger and healthier people.

In January of this year, my colleague the Minister for Health, Deputy Reilly, announced changes which will help to make private health insurance more affordable for older people. Since 1 January 2012 there has been an enhanced age-related income tax credit for each insured person aged 60 years or over. Community rating of health insurance is at the very heart of our system and will remain so under universal health insurance. Risk equalisation protects community rating by spreading the burden of health care costs between the young and the old, the healthy and the less healthy. The Minister is unhappy about the trend towards segmentation in the market and has raised the issue directly with the insurers. He has consistently raised the issue of costs with health insurers and is determined to address costs in the sector in the interests of consumers.

The programme for Government contains a commitment to establish a permanent scheme of risk equalisation. This is a key requirement and is designed to keep health insurance affordable for older persons and to maintain the stability of the market. The Government agreed to the Minister's proposals for an improved risk equalisation scheme and published the Health Insurance (Amendment) Bill 2012 on 18 October. The new Bill will introduce a permanent risk equalisation scheme, RES, effective from 1 January 2013. There are some important differences and improvements compared to the current interim scheme which the RES 2013 replaces. In order to deal with issues of affordability, there will be two levels of cover: advanced cover, to which higher risk equalisation credits and higher stamp duty will apply, for public and private hospital plans; and non-advanced cover, to which lower risk equalisation credits and lower stamp duty will apply, for public-hospital-only plans. In addition, the new RES will allow for a greater number of risk factors, including age, gender and type of cover as well as measures of health status. A risk equalisation credit based on bed usage is proposed as a measure of health status.

In respect of access to public hospitals, as referred to by Deputy McGrath, the work of the special delivery unit, SDU, continues to focus on improving waiting times for access to both scheduled and unscheduled treatments and to maximise the capacity of existing facilities to manage patient flow. Since July 2011, when the SDU was set up, the number of people having to wait more than 12 months for treatment has fallen by 85% and the number having to wait more than nine months has fallen by 91.1%. The overall waiting list has reduced by 16%.

The Government's clear objective is for the health insurance market to remain as competitive and affordable as possible as we move towards a new system of universal health insurance. The Minister, Deputy Reilly, will continue to explore any available measures to limit the costs related to health insurance.

Deputy Billy Kelleher

I welcome the reply by the Minister of State, but the difficulty is that people and families throughout the country simply cannot afford to continue to pay the increases. There have been alarming increases in the private health insurance market in recent years. While we welcome competition and the opening up of the market, something must done to address the issue of spiralling increases in the cost of health care and health insurance in this country, including dealing with consultant hospital contracts. In addition, the decision to charge full costs for private patients in public beds is increasing the cost of health insurance. That is clearly a policy decision. I ask the Minister of State to convey to the Minister the deep concern of many people about the escalating cost of private health cover for families.

Deputy Mattie McGrath

I too am very disappointed in the reply. I know the Minister of State was only reading out on behalf of the Minister what she received from the Department. The Government is supposed to have agreed to the Minister's proposals for an improved risk equalisation scheme, but we are not getting this. We are being charged more and more for health insurance. I have a large family and our insurance continues to rise. That is my situation and I can hardly continue with it. One goes for a procedure in a hospital and finds there is less and less cover. Pure rip-off Ireland is alive and well.

I accept this did not all happen under the tenure of the present Minister during the past 18 months, but costs have increased three times since he came to power. The insurers must be taken on, called aside and told to stop. We cannot keep crucifying the ordinary people and trying to draw blood from a stone. There is no blood in the stone - people do not have the money. The increases attack the efforts that have been made to cut waiting lists, procedure times and everything else in hospitals. Too much is being taken out in this regard. Consultants are using public facilities and we are being screwed, although I hate to use that word. It is an awful situation and it is untenable.

I look forward to meeting the representatives tomorrow at the committee, but the Government must act. It is in charge and must cry halt to rip-off Ireland.

Deputy Jan O'Sullivan

It is certainly not today or yesterday that these increases happened.

Deputy Mattie McGrath

I accept that.

Deputy Jan O'Sullivan

In spite of the money that was in the country, there was no reform of the health service. The universal system to which the current Government is committed will address inefficiencies and extra costs in the health service and will deliver improvements for patients. A risk equalisation scheme is to be introduced by the Minister under the legislation he has introduced. The scheme in place under the former Government was struck down a long time before that Government fell and no permanent scheme was put in its place. What we are getting now is reform and new legislation.

I hope Deputy Billy Kelleher is not suggesting health insurers should not pay what is rightfully owed in the context of the use of private beds in public hospitals. One would expect that they would pay in respect of private patients in public hospitals.

A great deal of reform is taking place under the Minister. That reform will continue and assist in delivering more efficient and effective care for patients and better value for money.