Alex White (Dublin South, Labour) | Oireachtas source

I will try to be brief and not repeat any of the points that the Minister has made. He has covered many of the issues. Deputy Ó Caoláin welcomed free general practitioner, GP, care for children aged five years and under.

I welcome his welcome. There is a bigger point for the committee, which I wish to make without carrying it too far. In no area of public policy does it apply more than in health that we need co-operation and collaboration across the board in terms of the future funding and structure of the health service. I am not naïve. I am a politician just like most people in this room. The cut and thrust of politics will continue and nobody is complaining about that. In this area of health, given the demands on the health service and the ageing population, there are challenges for this country in terms of future funding of the health service. I would welcome the support and co-operation of colleagues across all parties on future funding. Not everything will be solved before 2016, although we hope many things will be solved by then. We must look to the years ahead for the entire population. This is one area of public policy where we could give ourselves a bit of space to try to work together on the best ways to fund, for example, universal access to primary care and, ultimately, as the Minister said, universal health insurance. In that context, I thank Deputy Ó Caoláin. When he looks for assurance as to whether this is a one-off; this is not a one-off. This is not, as has been described by some, a stunt or a gimmick. It was clearly set out in the programme for Government and emphasised again in the Future Health document. This is a key element of the reform of the health service and it will be carried forward.

I was asked to do essentially two things in July; one related to the interim measure and the other was to bring forward proposals in respect of elaborating the full roll-out. That work continues in conjunction with the Minister, Deputy Reilly. I look forward to more engagement on it as time progresses. The second issue relates to discretionary medical cards in general. The two issues are linked. They have been put together. The controversy arose in recent weeks and then we had the budget. They are linked in this way. I do not think that anybody should have to fight for discretion or even to pass a means test in order to have their basic health care satisfied. That is the system we have in this country and we are trying to change it. We cannot do it overnight. We must maintain the integrity of the system the Oireachtas has put in place, which is the 1970 Act, and at the same time we must bring forward the reforms to change the basis on which health care is allocated.

We are in the position where we have to do both simultaneously. It is not open to the Government or the Minister for Health to instruct the primary care reimbursement service, PCRS, or the HSE, much as we would like to do so on a personal level sometimes, to allocate medical cards on the basis of medical need. We simply cannot do that. The legislation does not allow us to do that. There are so many heart-breaking stories in newspapers and on the radio and television about people or their children who have a medical condition that has caused them so much distress. We can all see that some people are in difficult heart-rending circumstances but it is their income that determines whether they get a medical card. That is the tragedy. That is the law we currently have. Let us try to work together to change that. In the meantime, we cannot change the basis upon which a medical card is allocated by stealth. It is not an illness system. Everyone in this room knows the situation. We are all human, and so too are the people in the PCRS and the HSE. They also have empathy. The suggestion that they do not – not by people in this room – is not fair.