Seán Sherlock (Cork East, Labour)

The amendment in the Bill that replaces section 45(5)(a) of the Health Act 1970, coupled with the fair deal legislation on nursing homes, by their very nature, seek to destroy any semblance of public provision and universality in the health care system, as it relates to older people. The research indicates that 20,000 people who have had access to a medical card will no longer have such an entitlement. This sends the wrong message about how the country deals with public health to those who are in their autumn years. Notwithstanding the pre-existing deal done with general pracititioners, whereby the payment per patient would be significantly more than it is today, the health outcomes for patients in that category were significantly better as a result of having a universal right to a medical card. For men, in particular, having the medical card meant a much greater likelihood that they would go to their GP to monitor their health. I know of people in my constituency who were more inclined to go because they had the medical card. From talking to GPs, I also know that they achieved far better outcomes for their patients owing to the entitlement to a medical card. When we talk about public health and primary care provision which is woefully inadequate in the part of the country that I represent, I do not understand why the Minister would row back on a decision made to provide a medical card when the net benefit to the Exchequer is positive in terms of improved health outcomes because it keeps people out of secondary and tertiary care facilities.

Fianna Fáil backbenchers spoke about hysteria and the media frenzy whipped up over this issue. The people who marched on Leinster House were not whipped up into a frenzy of hysteria. At the time they took the rational view that their rights were being undermined. They were rightfully fearful of the possibility that their entitlements would be taken from them in one fell swoop. I am glad they decided to organise and exercise their right to protest. If they had not done so, we would not be here today and the Government would not have rowed back on the position it took on this issue on budget day. If we are to exercise public health policy correctly, it is clear that the campaign to maintain the automatic right to a medical card will need to have a positive outcome. We need to continue in that vein. I do not see how the Minister will be able to garner savings in this instance. It seems that she intends to reallocate resources from those whose automatic entitlement is being withdrawn to others who might be able to avail of a medical card. People on lower incomes will not receive a medical card in the current climate because the thresholds have not been increased sufficiently.

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