MINISTER FOR Health James Reilly said there had been a “modest” reduction in the number of people covered by private health insurance.

He said 46,000 people had left the insurance market between the end of March 2007 and the same month this year. This represented 2 per cent of the overall market.

“Some 2.139 million people, 46.6 per cent of the population, are still covered by private health insurance,” he added.

The Minister was responding to Fianna Fáil health spokesman Billy Kelleher, who said the private health insurance system was in crisis. “Many families are opting out of private health cover altogether,” he said. “We now have a situation where people are downgrading the insurance package they normally take out.”

There was increasing evidence, he said, that health insurance operators did not provide adequate cover in the sense that they were changing the terms and conditions of policyholders. This was particularly so in the case of older people.

The VHI, he said, had failed to cover the Mahon private hospital in Cork, and it remained closed.

Dr Reilly said everybody understood that nothing was free and that somebody must pay.

“However, we are discussing making something free at the point of delivery so that no one need to be concerned about being able to pay,” he added.

He hoped, he said, that all sides of the House agreed on that point.

“We do not want a situation in which someone must make a decision between attending a doctor or paying an ESB bill,” he added.

Dr Reilly said the Government was committed to a fundamental reform of healthcare that would deliver a single-tier system, supported by universal health insurance. Access would be based on need, not income. He said a new insurance fund would subsidise or pay insurance premiums for those who qualified for a subsidy.