John Dennehy (Cork South Central, Fianna Fail)

I welcome the opportunity to contribute to the debate on this Bill. We are all well aware of the reason this legislation is before the House; it is to create a legal framework to apply a reasonable level of charge for the maintenance element of long-term, public residential care units and to create the legal process whereby 200,000 extra people can be granted medical cards which will permit a doctor's visit without charge.

I welcome the decision to extend the provision of medical cards. The number of additional cards is estimated at 200,000. We have had an assurance that if the figure employed for eligibility — that is, 25% above the current level — does not lead to an extra 200,000 people obtaining cards, it will be modified to do so. A sum of €60 million has been allocated to that end.

Over the years, many representatives of all parties on health boards and elsewhere have requested such facilities. Various descriptions were used, including limited liability, but it basically concerned the introduction of a second type of medical card. That concept was strongly supported over the years. I have heard the request being made by members of all political parties at public meetings, on health boards and on the Committee on Health and Children. Many interest groups, including GPs, have sought a similar facility. The rationale behind the request for GP-only medical cards was that in many instances no treatment, other than a doctor's examination and reassurance, is required for patients. The cost of visiting a GP was an inhibiting factor for some people. In some instances, parents became sick from stress and anxiety over their concerns for their children's health. GPs have made the case that often a simple examination can reassure a patient and if further treatment is necessary they can point them in the right direction.

The worst possible form of politics is for party spokespersons to try to denigrate this positive and constructive move by labelling these cards as "yellow pack", thus suggesting that they are of little or no benefit. The latest attempt in this regard was made by our friend in Sinn Féin, Deputy Ó Caoláin. He said that others referred to the cards as "yellow packs", but that was just adding the same tag to them. Not only is this the worst possible type of politics but it is also patently untrue to say the GP-only cards are of no benefit to anyone. Some €60 million will be invested in the scheme this year to the benefit of 200,000 people. Apart from any other aspect, that is proof of the benefits involved.

The scheme will apply to those who are marginally above the current eligibility limits for medical cards. We have been seeking a re-examination of the situation to target that group and this is now being done. It would be almost impossible to draw up a scheme to provide 200,000 extra medical cards for full eligibility because, as we all know, the cost of drugs is open-ended. Unfortunately, in the past, we found that in many cases there was not much control in this area, even though we had concerns about it. We can quantify the cost of medical cards directly, while we could not do so for the supply of drugs, although there is a separate scheme in place for that. The bottom line is that at least €60 million is being diverted from other areas to a targeted group of people who are less well off.

Political honesty is required from those who oppose this scheme. There is a clearly identifiable group who require preferential treatment, including targeted services. The GP-only card scheme goes some way towards meeting their needs. This kind of targeting includes the medical cards for the over-70s scheme, which has been opposed by several speakers today. I campaigned to extend that scheme to include the over-65s so they would automatically become eligible for a medical card. Many of my colleagues, from all parties, who served on the Southern Health Board were anxious to implement such a scheme.

I am intensely annoyed by the mischievous comments that have been made about the proposed scheme, particularly when the commentators were among those who campaigned for such a scheme over the years. Last night we heard a further outburst in that regard when one Deputy from the west, who shall remain nameless, told us that we were giving medical cards to billionaires. I am sure they are running down to the doctor every day, card in hand, seeking some service. Perhaps his previous claim that we gave cards to millionaires no longer made the headlines, so he changed the story a bit.

When the occasion demands it the commentators can come in here and paint a vivid picture of the deprivation being suffered by people in certain circumstances. They can make certain cases in an almost tearful manner. In spite of that, if they hold clinics, they know that some of the greatest cases of hardship were among elderly people without a medical card. These people were fortunate enough to have a small private pension, but they were unfortunate in the sense that it resulted in them being over the means threshold for a medical card. Desperation was evident among these elderly who were in need of health care. In some cases that might only amount to reassurance on their health concerns. This group was in need of particular help and attention and I am proud we gave them that assistance.

Much has been made of the scheme for two unfortunate reasons. First, the Departments involved could not supply a figure for the number of people who would be eligible. In other words, as Deputy Olivia Mitchell stated, they did not know the number of people in the country aged over 70. That was a fact. That should not change the concept of giving benefit where it was needed. The second reason is that the IMO, the doctors' union, was able to hammer out a very good deal. It certainly got the last ounce out of that measure. I still believe that this was a good decision.

I cannot imagine any millionaire or billionaire going down to join a queue at a doctor's surgery to get the benefit of his or her medical card. That type of emotive statement should not be made. What happens is that because of the negative things that have been said, people will shy away from worthwhile schemes. I ask that people be more positive, especially when dealing with the elderly.

The critics love to refer to the elderly as the people who built the State. They say that we owe them and should give more to them. However, we indulge in saying the opposite to attack the former Minister, Deputy Martin, or the Minister, Deputy Harney.

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