Martin Mansergh (Tipperary South, Fianna Fail)

——for people over 70 years. Even with this measure the cost of medical cards will rise by 14% next year. I favoured its introduction, mainly on grounds of the reassurance it would give to people whose medical problems, on average, increase with age.

Going back to the 1940s and the 1950s the medical profession mostly opposed, with success, the introduction of a universal health care system here such as the national health service across the water. As Parliamentary Secretary, Dr. Ward, was responsible for pioneering the health service here from 1932 to 1946 but he was brought down by a so-called scandal induced by medical interests. A few years later Dr. Browne was also effectively brought down by the same profession that earned, and still does earn, a very comfortable income from the better off members of the community.

For better or for worse, therefore, we did not opt for an NHS-type of service, although those systems also have plenty of problems of their own, as do mostly private or insurance-based systems. We ended up with what can best be described as a dual, mixed system with considerable overlaps. Approximately 50% of the population, if not more, have health insurance assisted by tax breaks together with some public entitlements. Should this system be departed from, let us say for the under 18s or the over 70s the case can certainly be made, especially when resources are abundant, but there is also an argument as to whether either constitute the best use of resources. The medical card was introduced a few years ago for the over 70s but it faced palpable reluctance from the medical profession then led by an IMO president who is now the Fine Gael health spokesperson, who insisted on disproportionate compensation.

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