Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I reiterate that if the extension of these cards to those under the age of six and over the age of 70 is the only thing we do, it will not be worth doing. It was never intended to be anything other than a first step. One of the first steps towards universal health care in Ireland was taken in the late 1940s and 1950s, when efforts were made to introduce the mother and child scheme. It is a pity is stopped there. The same arguments were made at the time against the mother and child scheme, which was originally proposed by Dr. Noël Browne and, in fairness, was actually brought in by Fianna Fáil. Dr. Browne did not manage to bring it in. It was brought in by the subsequent Fianna Fáil Government and it all stopped there. It is a pity we did not do something like that every three or four years.

Had that been done, we would have universal health care by now. What needs to be done as part of the roll-out of universal health care is not just the roll-out to six to 12 year olds and then twelve to 18 year olds; it is a new medicines reimbursement scheme. The current scheme is Byzantine and unfair. There is the long-term illness scheme, under which some people pay nothing, no matter how wealthy they are; a medical card scheme under which people, some of whom are extremely poor, pay up to €25; and then there is the drugs payment scheme for everyone else, which is based on a monthly payment. It is not a good system. In a few weeks' time, Members will see proposals in my party's manifesto as to how we might resolve all of that, or at least come up with a fairer scheme. That would be the medicines element of it. The Deputy is right to say that the €10 million is there because it is anticipated that we could bring in the next step - GP care without fees for children aged six to ten - starting in Q4. However, we have always made it very clear that we would not impose this on the GPs ahead of an agreement on a new contract, so it will not be a standalone contract in the way the under-sixes contract was. It would form part of the new contract that we hope to agree with the IMO, which I imagine will include things other than the roll-out to six to 12 year olds. It will include supports for rural practice and urban deprived areas, chronic disease management and other measures. I hope we can agree that by the end of March.