Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I welcome the Minister of State, Deputy Alex White. The backdrop to our discussion is as inauspicious as anybody could ever imagine. I have always been willing to accept that the universal roll-out of free GP care should be done in a programmed way. As I have argued repeatedly, it must be introduced in a timeframed fashion, with a clear understanding by citizens of what is being done, which will, in turn, increase the potential for general population acceptance. I have been willing to play my part in encouraging that acceptance across the board.

However, the timing of the Government's initiatives in this regard has been terrible. Simultaneous with the proposal for the roll-out of a free GP care entitlement to all children under the age of six has been a very proactive targeting of people with discretionary medical cards based on medical need rather than the simplistic assessment that applies across the board of ability to pay. The discretionary mechanism is reflective of the fact that particular medical needs impose additional and quantifiable burdens on individuals and families. The extent of the hurt and anguish caused by this targeting is palpable. We have reflected it time after time in this committee room, in the Dáil Chamber and by every other means open to us. Until this week, however, there has been a persistent denial by the Government, despite all the evidence, of what is happening. I have concluded that we should have elections more often because they are a powerful wake-up call for the parties in government.

The situation in regard to discretionary medical cards has made the position of Government in respect of the particular proposition in this Bill very difficult. It has made it equally difficult for those of us in opposition who are willing to consider and facilitate measures which can ultimately deliver something that will not only be welcome but will most certainly be in the public interest and for the public good. Free access to GP care is an essential and integral building block towards a universal health care roll-out, which is what I want to see achieved in my time in this institution. However, I cannot be confident at this point in time that it will be achieved. The handling of all of these matters has been absolutely atrocious.

In his opening remarks, the Minister of State said: "[M]y concern was to ensure that we roll out the universal service in the quickest and most efficient way." I am up for that, but I need him to say this morning what this statement translates into at this point in time, according to his understanding. There is nothing efficient about the way in which all of these matters have unfolded. While the proposition contained in the Bill is laudable of itself, the backdrop - a backdrop created by the Government - has been deplorable.

The Minister of State also said "I believe that this current Bill will provide the basis for the progressive expansion of universal GP coverage to other age cohorts." I am concerned by the fact that the Minister did not say it would be extended to all cohorts. The use of the term "other age cohorts" indicates that the policy in this regard is piecemeal. I want to know what will be the final position and I need - and members of the general population have a right - to understand what is the timeframe in respect of this matter. That is absolutely essential.

In the context of the backdrop, I have a few short questions. At issue here are families with dependent children up to six years of age. Many of those families previously held medical cards and were among the cohort who lost those cards in the course of the discretionary medical card review process. For a variety of reasons, but primarily because such was the focus of Government intent in respect of probity, they did not fulfil all of the requirements involved and, therefore, they do not tick the box relating to the second criterion laid down by the Government, and articulated yesterday by John Hennessy, director of primary care, on "Morning Ireland", with regard to qualification for the restoration of their medical cards under the decision announced by the Cabinet on Tuesday. Among the people to whom I refer, there will be those who will not tick all the boxes when it comes to the three criteria and whose circumstances are more gravely serious than some who will have their cards restored. In other words, their circumstances are going to be compounded by that restrictive decision.

I wish to inquire about those who applied for discretionary medical cards in the period 1 July 2011 to 31 May 2014. As a result of the fact that the same criteria used during the review process were applied to them, their applications were refused. The Minister's apology is fine, as is that of the Taoiseach. However, those apologies do not correct the serious financial hit and hurt which people were obliged to endure during the period in question. Cards are due to be restored to more than 15,000 people who previously held them. However, had matters been left as they were, those to whom I refer would not have been obliged to carry a further financial burden at a time when they had no capacity to cope. I ask that the Minister of State address these matters. I am of the view that the reimbursement of those individuals and families must be a critical part of any package to be introduced.