Seán Fleming (Laois-Offaly, Fianna Fail) | Oireachtas source

Some 35,000 elderly people are watching today who will lose their medical cards as a result of this decision. In fact, it was based on the Minister making a reduction of €200, but the figure is probably higher at €300 per couple.

The medical card is highly valued by older people and those on low incomes. It provides reassurance and a right of access to health care at a time in their lives when they are more likely to have significant health care needs.

Many of the services required by these elderly people are not easily accessed through private health care, yet the Minister has today cut the tax relief for private health care insurance for many of the elderly people who need good-quality health care packages because they cannot rely on the health care system, especially now that he has reduced the availability of medical cards. Some elderly people will be hit through the income tax relief for private health insurance while others will be hit through the removal of medical cards. There is a good reason to provide older people with free health care services. As we know, their physical health deteriorates as they get older.

One by one, the commitments made in the programme for Government in this regard are being abandoned. Universal health insurance will never see the light of day and the promised White Paper is a figment of the Minister's imagination. We were told there would be funding to provide more residential places, more home care packages and the delivery of more home help and other professional community services. The opposite is the reality. The Fair Deal scheme has a waiting list of 1,500 and is on the brink of collapse.

Last week, the Dáil debated a Fianna Fáil Private Members' motion on discretionary medical cards. When this Government took office 80,000 people in Ireland had a discretionary medical card on medical grounds. The figure today is 53,000. Of course, the Minister will say there is no policy to reduce the number of discretionary medical cards, but the facts demonstrate otherwise. When one looks past the headline figure, the situation is even worse. We have heard of cases in which applications were not granted in the case of young children with multiple complex conditions and adults with severe illnesses such as cancer and motor neuron disease. Many of our incapacitated senior citizens are also being denied medical cards under the practice operated by the HSE. There is a clear intent to reduce the number of people who have medical cards, regardless of their health care needs. Today's budget changes are a further step in this process.

There is one positive development with medical cards. The extension of the free GP card to children under five years of age is welcome. Everybody will agree with that. However, that will do nothing for the many families with young children over five years of age who suffer from serious medical conditions and are currently denied a medical card. It is shameful that the expansion of the categories of patient covered by the medical card scheme comes at the cost of reduced cover for core low-income groups. People have been refused discretionary medical cards even though they have been diagnosed with debilitating clinical conditions. This is simply not fair. It is worth recalling that it was only in August of this year that the Minister of State at the Department of Health wrote to parents in Galway to say the Department was unable to state when children with intellectual disabilities who are leaving school this year will be offered appropriate services due to the current funding situation. Parents were told that some places would be offered "which will not fully address individuals' requirements". The Government's original plan was to introduce so-called free services for long-term illness patients, but this proposal has floundered. The same might happen to the medical card scheme for children under five years of age.

The Minister is leaving. He probably has a media appointment. It is an example of the commitment of the Government to Dáil reform. After the vote on the Seanad last week the Government spoke about Dáil reform, but now, when most of the Opposition spokespersons have yet to speak on the budget, the Minister for Finance and the Minister for Public Expenditure and Reform have left the building.

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