Michael Harty (Clare, Independent) | Oireachtas source

I have a point about services for those aged under six years. Nobody is arguing about the expansion of free care services or services at low cost. In the past few years, however, we have seen the expansion of free GP care to those aged under six years - about an extra 240,000 children - persons in receipt of domiciliary care allowance and carer's allowance. At the same time, there was a reduction of 38% in resources for general practice. In the case of those aged under six years, what has happened is that the visitation rate has increased and general practice does not have the capacity to deal with the increase. As a result those aged under six years end up being brought to out-of-hours services which also do not have the capacity to deliver free care services. The children then end up in emergency departments. The presentation of children aged under six years in emergency departments has, therefore, increased since they were provided with free GP care. Children have not got any sicker in that time, but they have an entitlement to free GP care and if they do not receive it in general practice or out of hours, they will present at emergency departments. Entitlement can be expanded, but it will have that consequence if it is not matched by an expansion of capacity. Why would an emergency department see more children aged under six years when they have an entitlement to free GP care? It is because general practice does not have the capacity to take them on. That is where the policy does not match the practicalities.

We have touched on some aspects of the Sláintecare implementation strategy. Lost in translation, as I put it, has been the funding element and the issue of entitlement versus eligibility and the blurring of the lines in that regard. There has also been a loss of urgency. I do not get the impression from the Sláintecare implementation strategy that there is urgency. We are now two and a half years into the process and we still have not seen any policy change. Are there other elements the delegates can identify that have also been lost in translation? It is a broad question.