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Seanad Éireann díospóireacht -
Wednesday, 13 Nov 2013

Vol. 227 No. 8

Order of Business

Immediately after the Order of Business we will have tributes to a former colleague, the late Senator Eamon de Buitléar. The Order of Business is No. 1, Oireachtas (Ministerial and Parliamentary Offices) (Amendment) Bill 2013 - Committee Stage, to be taken at 1.30 p.m. and adjourned not later than 2.30 p.m., if not previously concluded; No. 2, Gas Regulation Bill 2013 – Committee Stage, to be taken at 2.30 p.m. and adjourned not later than 3.30 p.m., if not previously concluded; and No. 47, Private Members' business, motion No. 6 re electricity transmission network, to be taken at 4 p.m. and conclude not later than 6 p.m.

On many occasions in this House I have raised the issue of private health insurance and its costs, not just after the most recent budget with the reduction in tax relief on policies that the Minister for Finance, Deputy Noonan, called "gold plated". Last week his Department confirmed these changes will affect 1.1 million policies not the 500,000 originally estimated. That was a major hit for those prudently paying for private health insurance. Nearly 200,000 people have given up their policies in the last three years because they cannot afford it.

Yesterday the Minister for Health, Deputy James Reilly, announced an increase in the stamp duty on private health insurance cases by way of risk equalisation. That means an increase in policy premiums of approximately 15%. Most renewals are coming up between now and January and the Leader and everybody else here will have had people in contact about the increases in their health insurance policy costs. Laya Healthcare managing director Mr. Dónal Clancy said, "Rather than protect the most vulnerable patients as outlined by the Minister, the levy hike will only increase the burden on an already struggling public health system.” GloHealth chief executive Mr. Jim Dowdall said, “It is farcical, bizarre and absurd that the Minister continually calls on health insurers to drive down costs when Government policies have been the overwhelming driver of rising premiums in recent years.” Mr. Dermot Goode of Cornmarket Healthcare Division said, “Consumers are going to get clobbered," and that is a fact. Mr. Goode said the changes announced by the Minister would have an inflationary effect, even though the stamp duty was not levied on consumers, because insurers are likely to pass on the cost increases.

I raise this issue in the context of the much heralded universal health care the Minister and Government keep talking about. We have no White Paper or roadmap; we do not know where it is at. All the public and I see is discretionary medical cards and over 70s medical cards being removed and private health insurance premiums going through the roof forcing thousands of people to leave the system, which will put a further burden on the public health system. This is without the Minister, Deputy James Reilly, publishing the HSE service plan, due next week. The situation is going from bad to worse and is at crisis point. I wonder if the Government has any knowledge or feeling for what is happening. We will have further tens of thousands of people giving up private health insurance policies. They will come into the public health system, which is already creaking. The chief executives of the main hospitals in this city have already said they are at breaking point. Where are we going? The Minister for Health must make a statement on where he is going with universal health care. Are all these things he is doing part of the jigsaw to get us to the Dutch model? The Dutch are unpicking their system and moving back from it. I do not understand where the health plan is going.

Has the Leader a date from the Government on when it will introduce free GP care for those aged five years and under? The Minister announced this as a cloak. He said he would bring it in but there was no date and no consultation with the Irish Medical Organisation or the GPs. Incredibly, the week before last, he said he would introduce free GP care for all by 2016. What planet does he live on? He will have free GP care for all because nobody will have private health insurance. I am proposing an amendment to the Order of Business that the Minister come to the House for one hour to make a statement on universal health care and the situation with regard to private health insurance cover. It is far too serious for us to be raising the issue every morning and getting no statement from the Minister.

I have been seeking a debate on universal health insurance with the Minister, Deputy James Reilly. The Leader has said he will ask the Minister to come here. It is unreasonable to expect him to come here today, but it would be good to have the debate in order we can hear from the Minister about the steps that have been made towards universal health care such as the introduction of free primary care for those aged under six years. It would be good to hear from the Minister in detail about that in the near future.

Following the contributions many of us made on yesterday's Order of Business I welcome the news from the meeting of EU leaders that there is a very serious pledge to tackle youth unemployment. A funding stream of €6 billion in the EU fund specifically to implement the youth guarantee will be made available from 1 January 2014. As I said yesterday, the Minister for Social Protection, Deputy Joan Burton, has indicated she will come into this House to discuss with us in detail her plan for the implementation of the youth guarantee in Ireland. It is very important to see the Taoiseach committing to the four-month guarantee, that is that no young person would be on jobseeker's allowance for more than four months without having access to a work placement, traineeship or a place in further education and upskilling. It is very important that we have that debate.

I commend Ms Kitty Holland for her excellent but very harrowing piece in The Irish Times about the plight of the tracheotomy babies, children up to three years of age who are in Crumlin hospital for seemingly unnecessary periods awaiting a home care package from the HSE. It is hard to know what is the reason for this, but it would be good to have a debate with the Minister for Health on this issue or to hear from him why the HSE cannot make available the funding to enable these young children and babies to be brought home. There is no economic reason for this. It is far better economically, as well as emotionally for them and for their families, to have them cared for at home. In each of the seven cases Ms Holland described the parents have been trained to offer the 24 hour care needed and all that is required is for the home care package to be made available. It is a very serious matter if these children are being kept in a hospital longer than they need to be and it would be good to hear from the Minister as to why that is.

I second what Senator Darragh O'Brien has said about health insurance. We have known for a very long time that VHI has hidden behind its alleged-----

Is the Senator seconding the amendment?

Yes.

We have known for a long time that VHI has hidden behind its older profile of patients in order to impose levies on its competitors. This is another bailout today. I have raised several times in the House the Milliman report, which states:

While it is undoubtedly true that VHI has an older and (arguably) sicker population than its competitors, we believe limited focus has been given to utilisation management and investing in ways to manage claims that can yield savings regardless of the risk profile of its population. ... In all our discussions with VHI, there was minimal emphasis on issues around managing the quality of care given to patients and hence reducing claims cost by limiting inappropriate treatment with no proven medical benefit. Our experience in other markets and our data analysis leads us to believe this is likely to be a source of considerable potential savings.

We have relieved VHI of these efficiencies by continually asking the other companies to bail it out. While this report is heavily redacted, we see on page 31 that it states VHI’s admission rates are too high and there is an average length of stay of 10.6 days when the report estimates it would be 3.7 days in a well managed system. When we raised these points, the Government side said the McLoughlin report would answer some of this. However, it appears the Minister has acted before the McLoughlin report. We need to debate that urgently in the House. McLoughlin, who had previously implemented interesting reforms in local government, was to address these issues. The Leader has agreed that the use of the phrase "gold-plated" in the budget was inappropriate as over 90% of people will pay more because of the wish to clamp down on gold-plating. The gold-plating is in the VHI organisation. The consumer is not protected by the Health Insurance Authority which has been captured by the VHI company. If we have universal health care in that system, VHI will have the ability to tax everybody in the country. Now, it just imposes taxes on the rest of us who are not members of VHI. It is an entirely inappropriate way to run the health insurance market. We have been condemned in the Irish courts and the European courts. We need to find ways other than continuously supporting VHI with money transferred from its competitors. There must be better ways to run the health insurance system. We were hoping Mr. McLoughlin would have a chance to report on these issues and we need to debate what he has to say. However, it seems to me that the permanent government in the Department of Health will always defend VHI when it badly needs some competition.

I compliment the Garda Síochána on the fact that 7,000 people have been arrested in the last 18 months under Operation Fiacla which deals with burglaries around the country. This proves how widespread this problem is and, in particular, how vulnerable elderly people in rural Ireland are. Some 4,000 of these 7,000 people have now been charged and brought before the courts. As legislators, we have to ensure the proper supports are there for the Judiciary, the Minister for Justice and Equality and the Garda Síochána to deal with the people concerned. Many are repeat offenders and, when they are charged and let out on bail, they continue to commit crimes. The law should be changed. I ask the Leader to ask the Minister for Justice and Equality to come to the House at some stage for a debate on how we, as legislators, can bring in supports for the Judiciary, the Garda Síochána and the Department of Justice and Equality in dealing with the people concerned. I saw a newspaper report two weeks ago concerning a repeat offender who had more than 120 offences for shoplifting and more than 20 offences for driving without insurance but who had not been sentenced by a judge due to other circumstances. That is disgraceful. At this stage, we need to have a debate in the House on sentencing and the way criminals are dealt with. As I said, 7,000 people in 18 months is a lot of people arrested and shows that gardaí are doing a great job. Nonetheless, we have to make sure the supports are in place in order that, when they do catch the people concerned, they are dealt with properly.

I join my colleague, Senator Darragh O’Brien, in mentioning the revelations in the past 24 hours on health insurance. In anybody’s mind - following on from what Senator Colm Burke has said in recent weeks about the discourse on health being quite personalised against the Minister - it is simply impossible to ignore the calamity that appears to be the health service in terms of its funding. On the one hand, we are seeking to introduce, for the most wealthy in the country, free GP health care for those aged under five while on the other, we are screwing the coping classes to the wall by continually hitting them and expecting them to pony up more.

The cost for a family with two children for a year will be approximately an extra €328. Since 2009 the health levy has risen by 149% for an adult and 155% for a child. As Senator Darragh O'Brien said, we have had the CEOs of three major hospitals say they are beyond capacity and at breaking point. We have had €150 million in cuts to primary care, which has arguably contributed to the 10% rise in the number of people using accident and emergency departments. All of this comes against a backdrop in which the Minister is saying there will be free GP care for all by 2016 and then universal health care. It is worth noting that some academics are now saying universal health care is not the way to go. If people can afford to pay, I, for one, would like them to pay. I do not want multimillionaires to be subsidised by people who have nothing. I do not want multimillionaires to have free GP care for their children.

There is no wish to personalise this issue against the Minister. I do not doubt the man's commitment in wanting to do a better job, but the reality is that even a cursory look at the health service would give people the impression it was a complete headless chicken, a calamity and a major problem. Anybody who suggests otherwise is reminiscent of that Iraqi leader who said they were fully in control and winning the war when the tanks were outside the studio.

Noel Dempsey and Dermot Ahern, was it?

There must be a way to discuss what is actually going on.

Does the Senator have a question for the Leader?

Frankly, the question could not be clearer. Who is running the health service? How much is it going to cost? From where is the money coming? Why is middle Ireland constantly being screwed to the wall?

I believe the name given to the Iraqi was Chemical Ali. Maybe he was referring to the gentlemen who were previously standing outside Government Buildings saying everything was okay. I think they were the Chemical Alis of the time.

There is a new Chemical Ali now.

Is the Senator identifying himself?

Does Senator have a question for the Leader?

I agree with the call for a debate on the private health system. As has been noted, VHI welcomed the move by the Minister while the other companies were critical. There is a play going on between the different private companies-----

Of course, there is.

It is because we are all subsidising VHI and there is no competition because it is being run by the Government.

Senator Jimmy Harte to cotinue, without interruption.

A debate is needed on the whole health insurance system. Some of us were in Taiwan last January as part of a delegation. Taiwan has a similar system to ours, with both public and private services, but there were no waiting lists in Taiwan. We asked them why this was so and they said it was because the system there worked more efficiently. I believe the system can work efficiently if it is taken control of. During the years VHI was obviously a company that was, as the Senator said, subsidised by the taxpayer. There is now a competitive market and I believe market forces will come into play.

As a speaker on the other side of the House said, there are those who can afford expensive health insurance and others who cannot. We are moving to a system under which those who can afford private health care will pay for it, as they do in the United States. We are happy to have a debate on this issue but Members should not forget what happened to the health service under the last Government. The leader of the Fianna Fáil party was the Minister for Health and Children, although I do not want to rehash that argument. There is a storeroom out there somewhere filled with reports signed at the bottom by Deputy Micheál Martin.

What is the Senator's point?

That is an outrageous comment.

Senator Jimmy Harte is over time.

Deputy Micheál Martin does not read reports.

This is a problem not just for the Minister for Health, the Government or the Opposition; it is a problem for the nation. The health service is chronically dysfunctional, and playing party politics with the issue is of no use at all. The reality is that every party played a role in the disaster we are now facing. It was indeed Deputy Micheál Martin, as Minister for Health, who disestablished the existing regional health authorities and set up the Health Service Executive, but everybody considered it a good idea at the time. Unfortunately, the then Government lacked the courage to take on the bureaucracy that carried over from the previous system. As a result, our ratio of administrators to primary care deliverers is twice that in the neighbouring island of Britain. That is one of the most serious problems with the system.

This issue should be examined on an all-party basis. With that in mind, we might recommend that it be referred to the health committee. The principal job of the committee at this time should be to review the operation of the health service. I have had a wonderful experience of the health service and cannot speak highly enough of it. The treatment I received was the best in the world. However, I have platinum-plated insurance for which I intend to continue paying. I would not mind if I were bringing other people on board by paying extra. That does not bother me; it is how society should work. Another member of my family who was treated in the public system when she was critically ill some weeks ago received superb care. We should be careful not to dishearten the people who are working in the health service.

We must address the problems in accident and emergency departments, which are clogged up by utterly self-indulgent alcoholics and drug addicts who make a total hames of the place. There should be safe containment facilities for such people to ensure they do not endanger the health and well-being of hospital patients and staff. We are far too tolerant of that type of anti-social and dangerous behaviour.

To reiterate a point I have consistently made, we must exercise great care in taking on full responsibility for European legislation. Today, as on most days of late, several instruments relating to European legislative matters are set to pass through the House without debate. That tells its own story. It warns us that we should be very selective and prepare very well if we are taking on this important responsibility. There is certainly a role for the Seanad in this regard, but it must be done in a particular way, with adequate resources and adequate time. Nor should it detract from our primary obligation, which is to review legislation.

The Leader has clarified that No. 3 on the Order Paper is not being taken today. Private Members' business is No. 47, motion No. 6.

Did I say something different?

The Senator referred to No. 3.

Yes, No. 3 is a motion relating to EU business.

That motion is not being taken today.

At least one of these motions is being taken today.

No, not today.

To clarify, neither of the two motions relating to EU protocols is being taken today?

That is correct.

I thank the Cathaoirleach for his clarification. My point stands, however, in that they will be taken at some stage without debate.

I congratulate colleagues who took part in the Oireachtas fashion show in aid of motor neuron disease last night. Senators Trevor Ó Clochartaigh and Eamonn Coghlan, as well as all the ladies, looked fabulous. Senator Hildegarde Naughton even gave us a bar of a song. It was a great night for a very worthy cause. Well done to all.

Will the Leader arrange a debate on the sections of the Charities Act that have not yet been implemented, including the provisions relating to the establishment of a charities register? Such a register is needed and should be funded from the charity sector itself. Every time people put a euro into a bucket, buy a line or donate clothes, they are handing over something they have worked hard to obtain. The public would like to see the charity sector properly regulated in this country. There are many organisations doing phenomenal work on a shoestring budget but there are others, unfortunately, that are less noble in how they go about their business.

In order to safeguard the status of charities that do their business properly in guarding and protecting the moneys they receive to ensure it goes to the people who need it, there must be a properly regulated charities sector. The legislation is in place and only needs to be implemented. A debate on the charities sector would allow us to discuss on the floor of the Seanad the good work that is being done by so many charities and expose those which are less honourable in conducting their business.

I support the amendment to the Order of Business and join the calls for a debate on health care. There are many issues to be discussed with the Minister for Health. The rising cost of private health insurance, for example, has been raised by several colleagues. Those rising costs must be seen in the context of the Government's plan to build the system of health care delivery around universal health insurance. The premise of the Minister's model is that health care will be delivered through so-called competing private health insurers. As it stands, I do not see much evidence of competition between insurers, which is one of the challenges that will undoubtedly persist under any new system.

I would prefer to see a system of State-provided universal health care. People pay their taxes, PRSI and the universal social charge but will have to pay again for health care. That is unacceptable and perpetuates the two-tier model. We need a debate on the increases in private health insurance in the context of the model of health care delivery the Government has proposed.

Can the Leader confirm whether the Health Service Executive's national service plan for 2014 has been delivered to the Minister? It is an important document which will spell out where exactly the axe will fall for hospitals throughout the State. In its wake will come the regional plans and local hospital plans. The publication of the national service plan would be an opportune time to have the Minister in the House for a full debate on the plan itself as well as the issues that have been raised by Senators regarding private health insurance and the Government's favoured health care delivery model.

Before calling Senator Colm Burke, I welcome members of the Irish Naval Association to the Visitors Gallery.

One of the major problems in the provision of health care has been the total lack of planning. A simple example of this can be seen in the figures relating to dialysis services. There are more than 1,800 people receiving dialysis at this time, which equates to some 250,000 appointments in real terms, or 20% of day care procedures in the State. In Norway, by comparison, only 370 people are receiving dialysis and more than 300 kidney transplants are conducted in that country every year. In Ireland only 150 of those operations are carried out annually. This situation is a consequence of the lack of planning in the ten years from 2000 to 2010. If people are complaining about the health service, they must look, in the first instance, at the lack of planning.

The health care budget for next year is €5 billion less than it was five years ago, but the services are still being delivered. There are issues that need to be tackled, but the fundamentals are there. In maternity care, for instance, Ireland has among the lowest rates of maternal mortality and perinatal mortality in Europe. That is because we have a dedicated staff delivering a very good service. I support Senator David Norris's comments in this regard. We need to ensure that when there are cutbacks, services are maintained. Reducing the budget should not necessarily result in a reduction in services. On the contrary, it is about achieving better value for money. It is also about setting up proper structures. Another example of a lack of planning is the fact we have more than 2,000 junior doctors on six-month contracts. That particular system has been in place for the past 20 years and is no longer working. As a result, more than 65% of our graduates are leaving the system within 12 months of qualifying from medical college. That problem must be addressed.

According to the Minister, he is dealing with that issue. He is setting up a structure to ensure long-term, rather than six-month, contracts are offered to junior doctors. These are the issues we are dealing with.

There is a need for a debate on the structures of governance and the six hospital groups we are setting up. We need to look at the system of governance in respect of the area of community care and the system of governance that will be put in place. We have not had a debate on it and it is something we must have in terms of how it will be put in place, monitored and managed.

Ba mhaith liom tagairt a dhéanamh don fhadhb mhór atá sa tír seo i dtaca le daoine óga, idir 18 agus 25, a bhfuil dífhostaithe agus nach bhfuil deiseanna fostaíochta ar bith acu. Níl obair ar bith ar fáil dóibh agus níl aon tacaíocht ar fáil dóibh ó thaobh structhúir de ón Rialtas ach oiread.

Some 62,580 young people between the ages of 18 and 25 years are unemployed and on the live register. Over 4,000 of them come from County Donegal. There has been much talk about what is being done for young people and in the past 48 hours the Government has been quick to point out that it initiated proposals in that regard. However, the cut in the social welfare budget will affect 21,000 young people who are being asked by the Minister to go into education. There are only 3,250 places available so some 18,000 have no additional educational opportunities. If we are talking about policy, we need to be clear on what is being done. The recent OECD report, Getting Youth on the Job Track, reported that Ireland lacks a youth employment strategy and youth unemployment and youth emigration strategies. We are quick to hop on a plane to Paris and say there is a €6 billion fund available across Europe. That may be the case and Irish Ministers may be quick to claim it, but we can only be judged on what we do at home. The Government is only providing €14 million in next year's budget as part of its youth guarantee programme. According to the National Youth Council of Ireland, €273 million is required, of which the Government is providing only 5%. It is a drop in the ocean and it is not dealing with the issue. If they cannot obtain employment, young people are left with no option but to emigrate. I know one parish, Lettermacaward in west Donegal, in which 90% of the people between 18 and 25 years have left under the watch of the Government.

The Senator is way over time.

Let us have a debate shortly on the issue over four or five hours. Let us bring proposals to the table.

I add my voice to the news of the further increase in private health insurance at a time when we should encourage people to take out private health insurance. Obstacles are being put in their way. I echo the calls for the Minister to come to the House, although I understand it is not possible for him to come today. We should have a debate on the issue. We wake up every morning to hear about difficulties in the health service. This morning, I heard about children undergoing tracheotomy in Crumlin hospital. They cannot go home because the home care package is not in place. They are ready for home but unfortunately they are not able to return. The health system is a poisoned chalice for anyone to take up. I ask that the Minister comes in as early as possible to debate the issue of private health insurance and the health system in general.

I am compelled to raise the serious matter of the Irish Russian adoption crisis, about which I spoke on two previous occasions. I am in contact with Ms Lisa Fennessy and Ms Pamela O'Reilly, two of the women who are enduring a state of extreme uncertainty and emotional pain on this issue. While the couples in question very much appreciate the commitment of the Attorney General, Máire Whelan, to a possible retrospective clause in an amendment, we must continue to fight on behalf of these families, who remain in a state of limbo. We must urge the Minister for Children and Youth Affairs, Deputy Frances Fitzgerald, to stay on top of the issue and find a resolution as soon as possible. The Minister has been dealing with the issue since July and she would want to get her act together.

That is not fair.

The Russian babies and their potential parents' future rests in her hands. We must find a resolution as soon as possible.

The Senator is not supposed to name people.

I do not want anyone interrupting and giving their opinion. I recently submitted a parliamentary question on the issue to the Minister for Children and Youth Affairs asking if legislation would be amended retrospectively to allow the number of families who hold declarations of eligibility and suitability to adopt which were issued to them prior to 31 October 2010 and already have referrals of children in the Russian Federation to proceed with their stalled Russian adoptions, as previously indicated.

On a point of order, are Senators allowed table parliamentary questions?

Through a colleague in the Dáil.

That is not a point of order.

It is very well researched.

Does the Senator have a question for the Leader?

I received the following response from the Minister: "The advice of the Attorney General has been sought and I understand that in principle it is possible to enact legislation which could retrospectively extend the period of validity to declarations." I am urgently and passionately calling on the Minister to do something about the extreme pain she is putting people through. How would she like to be in this situation if she was waiting for years to adopt a baby?

That is ridiculous.

That is dreadful.

How would she like to feel it herself?

It is welcome that the ASTI and the Minister are now talking about resolving the issues between them. I congratulate the ASTI standing committee and its central executive committee on the responsible attitudes to planned industrial action. It has been kept to a minimum. For the good of the students of the country, I hope an early resolution can be brought to the dispute. The Minister is right to agree to have discussions with teachers on the implementation of the new junior certificate cycle. It is important that everyone is on board. I look forward to the secondary school students having an uninterrupted year. It is a very important time in their lives.

Senator Darragh O'Brien referred to private health insurance, as did a number of other Senators. It is important and everyone agrees the health insurers should drive down costs. The Minister should outline his plans for universal health insurance and provide an update in early course. I would prefer if he did so in this House. I will ask him to communicate his plans in that regard.

With regard to free GP care for those aged under five years, the Government is embarking on a major reform of the health system and the aim is to deliver a single-tier health service, supported by universal health insurance, where access is based on need rather than ability to pay. A number of important stepping stones are necessary to pave the way for the introduction of universal health insurance. Delivering the first phase of GP care in 2014 for children aged up to five years is a major step.

Every parent and grandparent knows the early years of family life are very expensive and we know the hard-working parents of 240,000 children will now be reassured that they can bring children to a doctor without having to pay for each appointment. Internationally, Ireland is only taking the first steps to catch up with the standard practice, which is clearly evident in western Europe, of operating a universal GP service. Following settlement of the health Estimate, the Minister for Health secured additional separate funding of €37 million for the introduction of free GP care for those under five years of age. The Estimate has been fully costed, based on current rates of reimbursement to GPs under the general medical services scheme, including capitation fees, practice support costs and other claimed costs. It is estimated that this measure will bring the proportion of the population with access to GP services without fees to almost 49%. Legislation will be required for the introduction of this reform which will commence in the Department of Health. That should answer Senator Darragh O'Brien's query.

Senator Ivana Bacik has welcomed the fact that over €200 million in finance from the European Union was announced yesterday for the youth guarantee, which is to be welcomed. With Senator Marie Moloney, the Senator also outlined the plight of children in Crumlin hospital and the delay in providing home care packages. That is a disgrace and should be acted on as a matter of urgency.

I welcome Senator Sean D. Barrett's comments on health insurance and hope we can have a debate on the issue. I understand the McLoughlin report is due in a matter of weeks.

Senator Pat O'Neill complimented the Garda on the work done as part of Operation Fiacla which has resulted in over 7,000 arrests and over 4,000 people being brought before the courts. The Minister for Justice and Equality has indicated that all necessary resources will be provided to combat a spate of burglaries. I join in complimenting the Garda on the efforts made in this regard.

I certainly agree with some of Senator Marc MacSharry's comments. Spending over €13 billion on a health service should be more than sufficient to fund a world class health service. There is no question about this. I also note Senator Jimmy Harte's points in that regard.

Senator David Norris asked that the issue of universal health insurance be referred to the health committee, which is probably an appropriate venue for such a debate on policy. He complimented those involved within the health service who provide such wonderful care for patients in hospital. I note his points on the clogging of accident and emergency units, which has been ongoing the length and breadth of the country. It is disgraceful that people with anti-social characteristics are terrifying those who are ill and waiting for a proper service.

Senator Martin Conway spoke about proper regulation of the charities sector and implementation of the relevant legislation.

Senator David Cullinane asked a question on the health service plan. The HSE has up until next Friday to submit the 2014 national service plan to the Minister for Health for consideration. After that date, the Minister will have 21 days to either approve or seek an amendment to the plan.

Senator Colm Burke pointed to the plight of junior doctors, as he has done consistently in the House, outlining the steps in place to address the problem which should have been dealt with many years ago. He also called for a debate on community care which we will try to arrange with the relevant Minister of State.

Senator Brian Ó Domhnaill spoke about youth unemployment and the youth guarantee. I gave a comprehensive reply on that issue yesterday on the Order of Business when I gave the correct figures to the House. I remind the Senator that we were losing 7,000 jobs a month on the watch of the last Government.

Senator Mary White commented on Irish Russian adoptions. It is disgraceful to suggest the Minister for Children and Youth Affairs, Deputy Frances Fitzgerald, who has taken a personal interest in the problem is not working sufficiently to solve the problem.

The Leader is dead right.

Representations have been made to the Russian authorities and the Attorney General. I assure the Senator the Minister is doing everything possible to find a lasting solution to the problem.

Action is required.

It is not an issue with which to play politics.

I do not play politics. People are suffering.

The Leader to continue, without interruption.

Senator Jim D'Arcy spoke about the resolution to the ASTI dispute, which we all welcome.

I do not propose to accept the amendment proposed to the Order of Business.

Senator Darragh O'Brien has proposed an amendment to the Order of Business: "That a debate with the Minister for Health on universal health care and private health insurance cover be taken today." Is the amendment being pressed?

Amendment put:
The Seanad divided: Tá, 16; Níl, 24.

  • Barrett, Sean D.
  • Crown, John.
  • Cullinane, David.
  • Daly, Mark.
  • Leyden, Terry.
  • MacSharry, Marc.
  • Mooney, Paschal.
  • Norris, David.
  • Ó Domhnaill, Brian.
  • Ó Murchú, Labhrás.
  • O'Brien, Darragh.
  • O'Donovan, Denis.
  • O'Sullivan, Ned.
  • van Turnhout, Jillian.
  • White, Mary M.
  • Wilson, Diarmuid.

Níl

  • Bacik, Ivana.
  • Brennan, Terry.
  • Burke, Colm.
  • Clune, Deirdre.
  • Coghlan, Paul.
  • Comiskey, Michael.
  • Conway, Martin.
  • Cummins, Maurice.
  • D'Arcy, Jim.
  • D'Arcy, Michael.
  • Gilroy, John.
  • Harte, Jimmy.
  • Henry, Imelda.
  • Higgins, Lorraine.
  • Keane, Cáit.
  • Moloney, Marie.
  • Moran, Mary.
  • Mulcahy, Tony.
  • Mullins, Michael.
  • Naughton, Hildegarde.
  • Noone, Catherine.
  • O'Keeffe, Susan.
  • O'Neill, Pat.
  • Sheahan, Tom.
Tellers: Tá, Senators Ned O'Sullivan and Diarmuid Wilson; Níl, Senators Ivana Bacik and Paul Coghlan.
Amendment declared lost.
Question, "That the Order of Business be agreed to," put and declared carried.
Barr
Roinn