Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

On universal access to primary care, including free GP care, I agree. It is worth saying that the measures we brought in towards the end of last year increased the total number by several hundred thousand children. The Deputy was critical of it at the time, as is her right, because she wants more to happen faster, but several hundred thousand children - I will seek the actual figure - were added. It is a serious step in the right direction. The Deputy will be aware that we have to have the capacity for this in primary care, and we are asking much of GPs at the moment. Obviously, they have been instrumental in the test and trace system and the vaccination programme. We are asking for pretty fundamental reform in terms of chronic disease management in the community. We have got rid of dot matrix printers for prescriptions on the public list system, which GPs are very happy about, as they are about the access to diagnostics within the community. The Deputy understands this issue very well. I would like it to move as quickly as possible. We increased provision by several hundred thousand last year but we have to ensure that the capacity is there as well. Nevertheless, the Deputy's point is very fair. We are signed up to universal healthcare and it is exactly what we need. As she pointed out, we are an outlier.

On drug costs, there are two issues, one of which relates to the new drug budget of €50 million. It was zero last year, so that is a very sizeable increase. A backlog of drugs from last year is being moved through at pace by the HSE. The €50 million will not reduce drug costs but rather provide for free, because it will be through the public system, some new drugs and existing drugs for new treatments, which will help.

A total of €45 million in the budget was allocated specifically for prescription charges. For prescription charges for the over-70s, it will reduce the charge per item from €1.50 to €1, while for the under-70s, the charge will fall from €2 to €1.50. The net effect, it is believed, is that it will benefit more than 1.5 million people with medical card eligibility, and the drug payment scheme threshold will reduce from €124 to €114. It is a €45 million step in the right direction.

The question on restructuring probably demands a longer conversation than we have time for now. I took a decision last year that during the pandemic, it would not be the right time to move to the regional structures. It was not that they are not the right way to go, and much work has been done on them. I think we are all broadly in agreement on the single greatest advantage of making the change, namely, joining up the budgets for acute care and community care because one of the big problems is the siloed budgeting activity. I took the call that the pandemic was not the right time to do this. Based on what has happened over the past year, I think that was probably the right call. What we have not yet answered, and it is the question the Deputy is now posing, is whether we have a time at which we expect to move to the regional structures, given that the pandemic will be behind us soon enough.

We do not have time but I can tell her that people who are involved and very bought into it are already agitating for us to begin moving in that direction again.