Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

While appreciating the shortness of time, I support the three amendments tabled in the names of Deputies Jan O'Sullivan and Reilly. In the Bill, the Minister specifies two categories of people who will be exempt from prescription charges, namely, children in care and people in receipt of methadone on prescription. Obviously, I support those exemptions as I wish to see everyone exempt. However, why did the Minister make these choices and not others? It is not obvious from the legislation or any comment by the Minister. As I noted, I want to see all categories exempted and that is the critical argument.

I agree with Deputy Jan O'Sullivan's amendment to exempt homeless people and those in immediate risk of death or serious deterioration in their medical condition, were they not to receive their medication. Deputy Reilly's amendment lists approximately 24 medical conditions that he proposes to exempt and I also support this. It would go some way towards ameliorating the impact of this legislation. However, a far better approach, on which all Opposition Members are of one mind, even with their respective amendments, would be to not adopt the Bill at all. My final appeal to the Minister is that even at this late stage, she would accept that this Bill should not be passed.

Before concluding, I have one question for the Minister. This measure is supposed to save money and is about raising and saving money in the context of the overall health budget. How does the Minister justify the continuing practice by the HSE of entering into contractual arrangements with local developers for the provision of primary care facilities when significant idle space already is in situ in HSE-owned buildings, including local hospital sites? I have never seen, and am unaware of the existence of, a directive to the HSE from the Minister or the Department stating the primary care facilities must not or cannot be located in existing acute hospital premises or other hospital facilities. The Minister should clarify this matter.

I refer to the just-exposed instance in Carlow where, at a cost of €1,000 per day, that is, €365,000 per annum, the HSE has acquired access to a newly constructed building to provide primary care facilities even though there is idle space aplenty within the local hospital site that could accommodate such services. This story is replicated in many locations nationwide and this constitutes waste and is where real savings could be addressed. It entails better HSE management to ensure there is no waste of money and not to penalise the poorest, that is, the medical card holders across the State. I refer to senior citizens and those who, because of their income base, are entitled to a medical card. To penalise them now would be an absolute disgrace.

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