Paul Gogarty (Dublin Mid West, Green Party)

The Minister is fully aware that more than 400 medical card patients were told at short notice that they had to change doctors by 1 November 2006. These clients live in Newcastle, Rathcoole, Saggart and Brittas, and as far afield as Clondalkin, Lucan and Tallaght. They have been enjoying a high level of patient care from their doctor for as long as 14 years. After all this time, however, it turns out that Dr. Graham is not qualified to practice as a general practitioner under the GMS scheme. Despite his qualifications as a consultant, EU legislation, as a member of the Minister's staff informed a meeting recently, prevents him from providing general practitioner services to medical card clients in his own right. I know the "whys" and "wherefores" and I also know that changing EU directives cannot be undertaken at short notice. Sometimes they cannot even be implemented in the long term but I am concerned about patient care. If patient care is truly at the heart of the Department's and the HSE's remit, a solution can and must be found.

I have met many of Dr. Graham's patients who are adamant that they do not wish to transfer to the doctors recommended by the HSE. Instead they want to continue being treated by him as their current GP. They insist they will not allow their medical records to be transferred. Many have personal reasons for this, which I do not wish to go into here, even under Dáil privilege. There are also issues of access and further issues regarding the suitability of the proposed new surgery, which some people have described charitably as a stable. However, the most important reason for wanting to maintain the status quo is that hundreds of clients have built up a long-standing relationship with Dr. Graham and they can see no logical reason for that relationship to be torn apart now. They trust their doctor and, for older patients in particular, trust is an important issue.

So far the HSE is not in favour of turning. It has behaved in a negative way. When my office contacted the HSE to get more information on the situation I was fed a cock and bull story. I was told the reason Dr. Graham would not be working as a medical card GP any more was that he had not applied for the position. As an elected representative, I expect more than to be treated in this manner. The poor treatment of Dr. Graham's patients is the most important issue, however. I urge the Minister to force the HSE to meet Dr. Graham's patients and come up with a workable solution that will acknowledge the situation regarding his continuing practice but will also allow him to continue to work with his medical card clients under whatever terminology and position is appropriate.

At the recent public meeting to which I referred, I highlighted the rapid manner in which the Government was able to introduce legislation when it was found to be illegally charging elderly people for nursing home care. It would be great if the Government applied itself so creatively to the needs of patients within the health service. The buck stops with the Minister. She should use her good offices to ensure that a solution is reached which is agreeable to all and which will allow Dr. Graham to continue providing his important services.

I do not want to hear excuses. The Minister and I share the same constituency. If she wants to use legal terms or say it is a matter for the HSE or that her hands are tied, that is up to her, but, if so, she will have let a lot of patients down. I hope the Minister will have some good news in her reply for our constituents. She should put patients' care first and let the people be treated by someone they know and trust. There are ways around this situation and they need to be explored.

See this speech in context