Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I will listen to that as well. However, if that is the Minister's stock-in-trade answer, then it is cold comfort to the thousands of families who are either contemplating dropping health insurance or having to reduce cover. If that is the only solution the Minister can find and the only answer he will give, then I genuinely hold out little hope.

We are now in 2013, half way through the lifetime of this Government, if it runs its full course. However, we have not seen the full implementation in terms of the review of the fair deal scheme and what exactly that will entail thereafter. This is another area of concern. I have no wish to sound alarmist but the Minister knows the demographics coming down the tracks as well as I do. All the statistics are available. Many of the difficulties that will arise are for reasons we welcome, in the context of people living longer healthier lives, improvements in medical technologies and medicines and the greater well-being of people generally. However, to go back to what the Minister is trying to achieve in terms of keeping people in their communities and in their homes, the policies in place are completely at variance with the objective.

We are discussing the Health (Amendment) Bill and therefore I wish to raise the broader policy of the Minister and the Government with regard to primary care. We have been waiting two and a half years for the first part of the Minister's programme for free general practitioner care for everyone. Last year, the Minister highlighted that there would be some legal issues and difficulties. We asked the Minister what these were but we did not get much of an answer. However, the difficulty is that the 60,000 people on the long-term illness scheme who were promised, in advance of the election, that they would be the first people to receive free GP care are still waiting two and a half years later. We are no wiser about what is happening with the roll-out of the programme. Given what has happened in terms of policy implementation and the impact it is having on people, I have considerable difficulty in understanding why the Minister is pursuing these policies.

We have discussed the need for community-based primary care services, the roll-out of centres, the development of physical structures, the establishment of primary care teams working closely with GPs and other health care professionals and the vision for change policy in terms of mental health and having all these services in the community. However, it is simply not working and there is no point in the Minister standing up in the House and pretending that it is. I will accept the criticism that progress was slow during the time of the last Government, but I had thought I would have been walking past health care centres dotted throughout the country by now, some two and a half years later. There has been a decidedly slow take-up.

I have no wish to go back over the old ground of the logarithmic logistical progressions and how the Minister assessed the primary care centres. The point is that even some of those placed on the list are not moving ahead either. Reference has been made to European investment funds to fund some of these primary care centres and public private partnership packages and so on. However, it is very slow and in the meantime people are waiting for the services.

Another alarming area is the Minister's comments on GPs. The Minister is himself a GP and has represented them in a previous incarnation. There has been no negotiations with the professionals who are expected to work in primary care teams and to lead them. That was to be the central tenet of how we had intended to provide health care in the country in the years ahead. I find it rather startling that while we talk the talk of establishing the teams and having the centres clinically led by GPs in the communities, there has been no genuine discussion with the organisations that represent them with regard to how this will actually work.

There has been no discussion on how primary care and free general practitioner, GP, care will work. There has been no discussion on how the contracts with the individual doctors will work. Moreover, although none of this has taken place, I am asked to come into the Chamber. As there are only 19 Fianna Fáil Members, our support or otherwise does not make much difference and we can only oppose on the grounds on which we choose. However, Fianna Fáil will oppose the Bill because the policies advocated and the policies pursued are completely different. Every decision Deputy Reilly has made since becoming Minister for Health does not coincide with what was put before the people in 2011. While one might argue things changed because of the formation of the coalition, I can find nothing in this legislation that correlates with the contents of the programme for Government.

In conclusion, this Bill is a tax on access to health care. It is an increase in taxes, as a charge is a charge no matter how one looks at it. People who present in public hospitals will be obliged to pay more either through the charges themselves or through the Minister's stealth tax with regard to increasing premiums for families nationwide who are as entitled as anyone else to access a public hospital and seek treatment in the public hospital system. Such people make sacrifices and lighten the burden on the State. They agree to pay their own private health insurance, thereby lightening the burden on the State and giving it a break. However, what the Minister has decided is they will pay their taxes and all their charges, after which the Government will levy them again when they actually access health care, even though they are not getting what they should, namely, treatment outside the designated beds that are present in the public hospital system. This simply is wrong and will put huge pressure on the health insurance market. More importantly, families throughout this country will pay for this flawed legislation.

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