Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

Citizens could be excused for believing this Bill is more accurately named than most legislation which presents in these Houses. The Health (Alteration of Criteria for Eligibility) Bill is not about the medical card in one's pocket; it is about the eligibility for health. This is what it comes down to in real terms for real people, citizens throughout the land.

The Minister of State, Deputy White, must hand it to his senior colleague at the Department of Health for sheer brass neck. The Minister, Deputy Reilly, has it all. We saw evidence of it here earlier this afternoon, with the nakedly obvious efforts he and his associates employed to close down ministerial accountability to the Dáil and the people. This was the Minister who made much of his stated intent to restore ministerial accountability on taking office, but this afternoon we saw a flagrant effort to stymie the opportunity for Opposition voices to hold him to account here in the Parliament of the land. There are buckets full of evidence from which to choose with regard to the Minister and brass neck.

In 2001 and 2002, he was head of the Irish Medical Organisation's GP section. He spoke publicly against the decision of the then Fianna Fáil and Progressive Democrats Government to extend the medical card without means test to people aged over 70. He then negotiated a hugely lucrative deal for general practitioners to provide care for these new over 70s medical card holders. Fast forward to 2008, when the Fianna Fáil and Green Party Government tried to row back on universal over 70s medical card entitlement, they quite rightly met a huge wave of opposition from older people.

Sinn Féin supported the over 70s non-means tested medical card because we consistently support the principle of universal eligibility for health care free at the point of delivery for all. Therefore, when the threat to withdraw it was made, we stood with older people in opposition. So too did the former Irish Medical Organisation negotiator, by then Fine Gael and Opposition health spokesperson, Dr. James Reilly. The then Deputy Reilly did not mince his words, as he rarely ever did on these benches over that time. He stated the threat to withdraw the over 70s card was a vicious attack and a savage assault on the elderly. I spoke from the Opposition benches also, as my party's health spokesperson, and I heard his words as I did at protest events organised by Age Action and others. When the Fianna Fáil and Green Party Government was forced to back down and introduce the current over 70s medical card scheme based on an income limit, then Deputy Reilly stated it was a desperate climbdown, that their efforts were tinkering with income limits and that it was nowhere near good enough.

The Minister, Deputy Reilly, championed Fine Gael's fair care health policy with its promise of universal primary care. The Fine Gael and Labour parties achieved a record mandate in the general election of 2011 on the basis of manifestoes which promised to greatly extend, and make universal, entitlement to free primary care. This is a laudable objective. In the Fine Gael and Labour parties' programme for Government we are told universal primary care will remove fees for general practitioner care and will be introduced in the Government's term of office. We are also told access to primary care without fees will be extended in the first year to claimants of free drugs under the long-term illness scheme at a cost of €70 million; access to primary care without fees will be extended in the second year to claimants of free drugs under the high-tech drugs scheme at a cost of €15 million; access to subsidised care will be extended to all in the next phase; and access to care without fees will be extended to all in the final phase.

The Minister, Deputy Reilly, promised the first phase, including the extension of free primary care to claimants of free drugs under the long-term illness scheme, would be in place by the summer of last year, but it was not as we well know. The explanation given was drafting difficulties because of the change from entitlement based on income to entitlement based on forms of illness. In the autumn of last year we were told by the Minister it was still on track and that there would be a Bill. Here we are today, 20 March 2013, and there is no Bill yet presenting to extend free primary care in any way whatsoever. On the contrary, we have this legislation, the Health (Alteration of Criteria for Eligibility) Bill 2013 which is designed to reduce the number of citizens entitled to free primary care under the medical card scheme.

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