Regina Doherty (Meath East, Fine Gael) | Oireachtas source

The Government's overarching goal is to ensure medical cards are issued to people who need them most. All factors are taken into account, in particular outcomes in regard to their medical condition. If somebody is terminally ill and the HSE, through the PCRS, learns about it, he or she will have confirmation of the granting of an emergency card within 24 hours. The cards are issued to people with serious illnesses, regardless of their incomes. Panels of doctors are now assessing applications for discretionary cards as opposed to the wink and the nod culture, to which Deputy Ann Phelan referred.

This motion is a complete puff of smoke by Fianna Fáil. It talks about the reduction of discretionary medical cards from 80,000 to 63,000 last year and a further 8,000 this year but what it fails to recognise is that of the 24,000 discretionary medical cards issued in that time, 23,000 of those people now have a medical card because of their entitlement and not because of the wink and nod culture where a Fianna Fáil person telephoned the PCRS or the former health boards instructing them to give the card. This Government is acting with probity.

It is no surprise that we have seen a reduction in the number of medical cards in recent months - probably more so than in previous months - and the return of medical cards to which people were not entitled. The money we are spending on our health service needs to be directed to the people who most need it. Those people who have incomes in excess of the threshold are not entitled to get medical cards.

The State cannot afford to pay for a medical card for everybody, regardless of means. Currently, almost half the population has access to free medical care funded by the State. According to HSE figures, in excess of 2 million people, or 45% of the population, have a means-tested medical card or GP visit medical card.

This Government's aim, which it will probably not achieve in its lifetime but please God it will do so in the future, is to give everybody access to universal health insurance, so there will be a one-tier medical service and not the current three-tier service or the two-tier service promulgated by the previous Government.

Medical services need to be delivered on the basis of the people's means, so that the money being spent by taxpayers follows the patient and their needs and not the way it was done in the past with a wink and a nod. This motion is a puff of smoke.

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