Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I have to raise an issue relating to the Primary Care Reimbursement Service that I was going to raise at the end. The provisions and anticipated costs for the roll-out of free GP care in the coming year are outlined in the documentation we have been given. This is really an issue of access to health care, which has been narrowly defined by the Minister as access to GPs. Of course, there is means testing on a continual basis for medical cards. Unless I am reading it wrong, children are getting GP visit cards, in effect. That is why people have contrary views about how universal health care might be advanced. Many people are saying that someone who receives domiciliary care allowance, for example, should get a medical card. It would be straightforward. If someone meets the terms of the means test for the domiciliary care allowance, why not give him or her a medical card? In such circumstances, at least medical cards would be targeted at those who are most in need of them. While it is fine to give GP cards to kids under the age of six, the reality is that means testing for medical cards is continuing. I have yet to find a medical card that is not means tested. That is the grave difficulty.

I am getting going on this. While there have been improvements in facilitating medical cards on a discretionary basis, in many cases it is still like pulling teeth to a certain extent. I know there has been a major increase of approximately 95,000 in the number of discretionary medical cards in the system. That dramatic increase has resulted from a change in policy. The policy that was reversed was denied for 18 months before this policy change took place. I think we need to look at this entire area. The Minister speaks about universal health care and everything that flows from it but I think the policy of rolling out free GP services to the whole nation at a time when people in any age cohort who are already in receipt of domiciliary care allowance are being asked to undergo a means test when applying for a medical card should be looked at very quickly. It makes sense to look at it. I am no expert in this area but I suggest that when the social welfare and health codes intermesh in places like this, one means test should be sufficient for the awarding of the medical card. My view is that such an approach would cut out a great deal of red tape. I think it is something the Minister should look at as a means of advancing universal health care, as opposed to universal access to a GP which is fundamentally not the same thing.