James Reilly (Dublin North, Fine Gael) | Oireachtas source

Yes. We covered some of the issues raised by Deputy Kelleher so I will not go over them again. I will ask Ms Laverne McGuinness to answer his questions about discretionary medical cards, because I do not believe the assessments have been random, as well as issues raised by others about the nursing homes support scheme and the supposed cuts there.

Deputy Kelleher mentioned the drug deal with the IPHA, which will save €400 million. We have allocated €210 million which will possibly be taken up over that time for new drugs. That is still a saving of €190 million, which is far more than the amount in the original deal, around €125 million.

Deputy Kelleher also raised the issue of the moratorium on staff recruitment for front-line services. I have always said that we would maintain the moratorium but show flexibility with regard to front-line staffing when this has been fully assessed and methods and models of care have been examined. I return to my point that in some model 4 hospitals we have a ratio of nine nurses to one health care assistant while in others it is only 2:8, so there is much work to be done. We know that was done in Cork and in the UK before that. It related to the fact that when they screened out orthopaedic referrals, physiotherapists could deal with 50% of patients themselves rather than sending them on to the orthopaedic surgeon. There is much ongoing work to be done. My greatest criticism of the HSE in the past was the fact that a national organisation failed to bring uniformity to the system. One would find things being done very well in one hospital and it would not be transposed across the system to other hospitals. The new hospital groups will certainly address that in a major way as there will only be six CEOs to deal with rather than 49.

Deputy Kelleher said we had been waiting for the roll-out of free GP care for two years, which is true. We have already covered this, in that we said we would do it in respect of the long-term illness scheme and health technology assessment but, given the legal problems that caused and the complexity of the system one would be setting up just for a temporary phase, we made the decision to go in a different direction. We will come back with some very distinct proposals to the Government in the next number of months. I know Deputy Kelleher has waited two years, but the previous Government had 14 years and nothing happened. He will forgive me for throwing that at him.