James Reilly (Dublin North, Fine Gael)

This Bill has been opposed by this side of the House and for good reason. I want to discuss some of the facts. There are 350,000 people over the age of 70 in Ireland and approximately 215,000, or 60%, have a medical card based on assessment. The other 40%, or 140,000, have a medical card on the basis of their age.

On 14 October the Minister announced that from 1 January the automatic entitlement would end and this cutback would save €100 million. We were very critical of this at the time because we felt this was taking the easy option and hitting the elderly rather than attempting to make savings through the renegotiation of the capitation rate offered to GPs, the prescribing of generic medicines and negotiations with pharmacists. A vote was forced on the issue. It is important to point out that many backbench TDs from the Government side spoke against this, but then voted for it. They certainly spoke out against it in their constituencies, but when it came to walking the walk, only Deputy Joe Behan walked.

The fact is that the over 70s medical card cost €220 million last year, while €86 million of this was attributed to GPs' fees. Following all the brouhaha, the Minister has managed to save €16 million, which gives lie to the spin that this was all about GPs' fees. It was more about the incompetence of a Minister who could have negotiated this with the pharmacists and the GPs, and left the over 70s with their medical cards and out of this row. She did not need to upset 350,000 pensioners and their families. Why did she not follow the internal advice given to her by the Department of Finance four days before the budget? Ultimately, she took that advice, but there was ample opportunity at the time to take a different route than the one she chose to take, which was to bring in the ban. She offered several different income levels and thresholds, which caused total confusion.

She maintains today that the bulk of people will keep their medical cards and that only 20,000 will lose them. However, the reality is that many people who are above that €700 gross threshold will not have a medical card. How many of these are retired schoolteachers, retired gardaí, retired nurses and other public and civil servants who have done the State some service? It is interesting to note that the IMO, in its submission, identified €80 million in drugs savings, which makes for €96 million in total when we add the amount saved by the Minister on fees.

I am very concerned about some of the provisions in this Bill. I obviously oppose the Bill, as I reject the Minister's idea that universality is not something that is achievable or affordable. I contend that it is, and we will implement it if afforded the opportunity in Government to do so. However, the Bill requires people to declare after 2 March whether they are eligible. The Bill is not clear on the consequences of that, as it alludes to another section in another Bill. I would like the Minister to spell out what happens to somebody who fails a means test after 2 March. What happens to somebody who is not good at filling out forms or who has a fear of forms, such as somebody in a nursing home who might be mildly confused? It is not clear how this will work and what the consequences are for people. There is very little information on the means test and there is no information on the conditions under which people who wish to apply due to changing circumstances will be considered ineligible.

One of the major issues I have with this Bill is the line which states the Minister will review and may change the threshold, with the consent of the Minister for Finance. There are two caveats in there for people. Having seen the record of the Government in keeping promises, people do not trust the Minister to do that. They would much prefer to see "shall" in that line, and have the Minister for Finance removed from the equation.

See this speech in context