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Ceisteanna ó Cheannairí (Atógáil) - Leaders' Questions (Resumed) (Continued)

Tuesday, 9 July 2019

Dáil Éireann Debate
Vol. 985 No. 2

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The Taoiseach: Information on Leo Varadkar Zoom on Leo Varadkar All of us meet people all of the time from all sorts of organisations and businesses. I bet none of us ever filled in a lobbying return-----

Deputy Bríd Smith: Information on Bríd Smith Zoom on Bríd Smith That date of 2 May is before the Taoiseach's party wanted the Ceann Comhairle to-----

The Taoiseach: Information on Leo Varadkar Zoom on Leo Varadkar -----because the obligation-----

Deputy Bríd Smith: Information on Bríd Smith Zoom on Bríd Smith That was just before the-----

An Leas-Cheann Comhairle: Information on Pat the Cope Gallagher Zoom on Pat the Cope Gallagher Deputy Bríd Smith has had her opportunity-----

Deputy Bríd Smith: Information on Bríd Smith Zoom on Bríd Smith -----money message.

An Leas-Cheann Comhairle: Information on Pat the Cope Gallagher Zoom on Pat the Cope Gallagher We are going to move on.

The Taoiseach: Information on Leo Varadkar Zoom on Leo Varadkar An Leas-Cheann Comhairle-----

An Leas-Cheann Comhairle: Information on Pat the Cope Gallagher Zoom on Pat the Cope Gallagher Deputy Smith, please-----

The Taoiseach: Information on Leo Varadkar Zoom on Leo Varadkar One always knows when somebody does not have a case. It is when there is an attempt to try to shout down people because the Deputies concerned do not want the answers to their questions. That is because they know that-----

Deputy Regina Doherty: Information on Regina Doherty Zoom on Regina Doherty Hear, hear.

The Taoiseach: Information on Leo Varadkar Zoom on Leo Varadkar -----what they are saying is-----

Deputy Bríd Smith: Information on Bríd Smith Zoom on Bríd Smith I will hear the Taoiseach's answers.

(Interruptions).

An Leas-Cheann Comhairle: Information on Pat the Cope Gallagher Zoom on Pat the Cope Gallagher Please, Deputy Smith-----

Deputy Bríd Smith: Information on Bríd Smith Zoom on Bríd Smith They do not stand up-----

The Taoiseach: Information on Leo Varadkar Zoom on Leo Varadkar -----untrue.

An Leas-Cheann Comhairle: Information on Pat the Cope Gallagher Zoom on Pat the Cope Gallagher Deputy Smith is being argumentative. I ask that the Taoiseach be heard without interruption.

Deputy Paul Murphy: Information on Paul Murphy Zoom on Paul Murphy The voice of big oil.

The Taoiseach: Information on Leo Varadkar Zoom on Leo Varadkar Where lobbying occurs, the obligation is always on the lobbyist-----

Deputy Paul Murphy: Information on Paul Murphy Zoom on Paul Murphy Come off it.

The Taoiseach: Information on Leo Varadkar Zoom on Leo Varadkar -----and not the person being lobbied to declare that.   If that is not the case, then every Deputy must have a case to answer. No person in this House has ever made a lobbying declaration but I bet-----

Deputy Bríd Smith: Information on Bríd Smith Zoom on Bríd Smith The Ceann Comhairle received a letter from the Taoiseach's Department-----

The Taoiseach: Information on Leo Varadkar Zoom on Leo Varadkar -----that every person in this House has been lobbied at some time.

Deputy Bríd Smith: Information on Bríd Smith Zoom on Bríd Smith -----after 2 May after which the money message-----

An Leas-Cheann Comhairle: Information on Pat the Cope Gallagher Zoom on Pat the Cope Gallagher Please allow the Taoiseach to speak. Deputy Smith is being totally disorderly. She knows the rules of this House.

Deputy Bríd Smith: Information on Bríd Smith Zoom on Bríd Smith Of course I am. I am totally angry.

(Interruptions).

An Leas-Cheann Comhairle: Information on Pat the Cope Gallagher Zoom on Pat the Cope Gallagher The Deputy can be angry but she cannot be disorderly.

Deputy Bríd Smith: Information on Bríd Smith Zoom on Bríd Smith Why not? They go together.

An Leas-Cheann Comhairle: Information on Pat the Cope Gallagher Zoom on Pat the Cope Gallagher They do not go together.

(Interruptions).

Deputy Timmy Dooley: Information on Timmy Dooley Zoom on Timmy Dooley This is the business of Parliament, not a pub.

An Leas-Cheann Comhairle: Information on Pat the Cope Gallagher Zoom on Pat the Cope Gallagher We will move on. I call the representative from the Independents 4 Change group. Deputy Joan Collins has three minutes.

Deputy Joan Collins: Information on Joan Collins Zoom on Joan Collins It recently came to light at a meeting of the Joint Committee on Health that private facilities, with separate entrances, would be provided at the new maternity and children's hospitals. These hospitals are being built with State funding at a high cost. A key element of the Sláintecare reforms of the health service is the removal of private practice from the public health system. It seems that the provision of private facilities in these two new public hospitals flies in the face of this key element of Sláintecare, namely, the separation of private medicine from the public system.

Under the Sláintecare action plan announced late last year, a report was commissioned on the issue of separation of public and private care. The report was to be produced by a group headed by Dr. Donal de Buitléir. I understand that such a report has been with the Minister for Health and his officials for some weeks now. Will the Minister make the de Buitléir report, and any recommendations it contains, public and available for discussion in the Dáil where the Sláintecare proposals received widespread cross-party support? Will the Taoiseach give a commitment that no private medical facilities will be planned or provided at the new maternity and children's hospitals? At the very least, will he give a commitment that this House will have an opportunity to debate the issues in the report before any such facilities are provided?

The Taoiseach: Information on Leo Varadkar Zoom on Leo Varadkar As I understand it, it is not the case that there will be separate entrances. There will, however, be a private clinic as there are at present at Crumlin children's hospital and the national maternity hospital at Holles Street, not too far from here. That clinic comprises a number of rooms in the building where private patients can be seen by consultants. Even across the water, for example, the National Health Service, NHS, in Britain also has private clinics. The Great Ormond Street Hospital, the centrepiece NHS hospital, has a private clinic. That is a recognition that some patients have private health insurance and are willing to pay for a second opinion.

Deputy Ruth Coppinger: Information on Ruth Coppinger Zoom on Ruth Coppinger Taxpayers should not have to pay.

The Taoiseach: Information on Leo Varadkar Zoom on Leo Varadkar Those private clinics bring in additional revenue for hospitals. Approximately €700 million is brought into our public health service every year in fees paid to hospitals, and not to consultants, for private patients. The de Buitléir report will be published as soon as the Minister is ready to do so. The report refers to the implementation of the recommendation in Sláintecare to disentangle public and private medicine in our hospitals. The term "disentangle" is a very good one. This is not something that can be done quickly or overnight. It involves a fundamental change to the consultants' contracts, for a start. That will have to be negotiated and will take time. A very long period may be involved where we phase out all contracts and replace them with new ones and that will also take some time to achieve. It will also be necessary to find €700 million or €800 million to compensate our public hospitals for the loss of private income. We should never forget that. Private patients do not just pay private income to consultants; they also pay private income to public hospitals. That loss of €700 million would have to be replaced or public services would have to be cut back as a result. I do not think that anybody wants that

Deputy Joan Collins: Information on Joan Collins Zoom on Joan Collins I asked the Taoiseach a simple question and I expected a simple answer. I only spent one and a half minutes asking my question so that the Taoiseach could not go off on a tangent. I asked a simple question. Will the Taoiseach make the de Buitléir report available to this House as soon as possible? I am referring to this week. The report has been in the hands of the Minister and the Department for the past number of weeks.


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