Mary Lou McDonald (Dublin Central, Sinn Fein) | Oireachtas source

The budget envisages a cut of €666 million to the health budget. One should bear in mind that the expenditure of the Department of Health routinely runs over budget. The Minister for Health, Deputy Reilly, for all his bluster, presides over that reality. Budget 2013 contained €1.173 billion in full-year cuts. At the time in question, the Minister for Public Expenditure and Reform, Deputy Howlin, presented the blanket figure with scant detail as to where specifically the savings would be found. Today's announcement is similar.

The Government's decision to extend free GP care to children of five years and underis welcome, but it can only be taken in the context of the removal of medical cards from thousands of very sick people. The Government, including the Taoiseach, has tried to deny the fact, but it is a fact none the less that removing discretionary medical cards from cancer patients and childrenwith complex medical needs is happening and is causing real hardship and distress. When the Minister for Health is challenged on this, he tells the cameras that these people have fallen through the cracks. I do not know who is he kidding. Katie Connolly from Cork is aged five and has fallen through the cracks, as the Minister would have it. She has Down's syndrome, asthma, a heart condition and juvenile arthritis, but she has been denied a medical card and a GP visit card. That is Katie's story. A response from the Government that she and her family have fallen through the cracks is simply not acceptable.

The decision to grant care to the under-fives must be considered in the context of the reality of a proposed €130 million cut affecting medical cards. The Government's documentation refers to "medical card probity", which is code for medical card cutbacks. Bizarrely, the Government has sought, over the past 48 hours or more, to court public popularity with a suggestion of granting medical cards to young children, while at the same time cooking the books and working up a strategy to introduce massive cutbacks in the general provision of medical cards. This is perverse.

Media reports - no doubt leaked by Government insiders - tell us the extension of GP care for the under-fives will be delivered in the new year, but we know from experience that there is no guarantee of this. The Minister for Health promised a GP card for all suffering with a long-term illness within his first year in government. Those with long-term illnesses, or real and complex medical needs, are still waiting for the promise to be kept. Katie and all the other Katies throughout the State need to be awarded their medical cards and to keep them. Nothing short of that will suffice.

Earlier, the Minister referred to mental health service provision and trumpeted the fact that €20 million is to be held for spending in that area. I am surprised that the Minister is not aware that the all-party mental health group sought a further €35 million in the budget. Very often, mental health services are referred to as the Cinderella of the health service. Let us say today, on budget day, that €20 million is not enough. In making the decision, the Ministers concerned knew full well, as they do now, that they were cutting the cloth too tight and that mental health services will remain under-resourced. We know this is happening at a time when the number of mental health problems, not least those causing deaths by suicide in this State, is reaching a chronic level.

The increase in the prescription charge to €2.50 per item, with a cap of €25, represents a very mean-spirited cut. It is all the more astonishing given that it is being introduced by people who fought tooth and nail against prescription charges in a previous incarnation. In the interest of joined-up thinking, did the Minister consider, when taking away the telephone allowance and making this decision on prescription charges, that it would prove to be a hit on the double for so many, including the elderly, carers and people with a disability? Did the Government join these dots or it is not the kind of thing it does? Perhaps it does not bother doing that sort of real, live thinking in the Economic Management Council.

The Government has failed to realise the huge savings possible through the use of generic drugs and by driving value-for-money deals with the large pharmaceutical companies. It is a real shame that more energy has not been dedicated to finding those real and substantial savings in the system. If it had done so more effectively, it could have kept its hands off people who rely on health and social supports.

The reference in today's budget to the front line was little more than the worst kind of gesture politics. We know the front line is under unbearable strain and that waiting lists for surgeries and procedures are growing. The HSE confirmed to me just this week that it cannot provide physiotherapy services to school-going children with disabilities. I refer to schoolchildren over five in the north-west Dublin region. The waiting list for children under five is over two years. Similarly, waiting lists for speech therapy for children are as long as two years. There is no joined-up focus among Departments. Today's three year old who needs speech therapy will become tomorrow's five year old in need of a special needs assistant because the necessary, and minor, intervention will not have been made earlier. It bears all the hallmarks of bad governance.

Third level students and their families have been hit again by today's announcement. To add to the insult of the SUSI debacle, there is the injury of hikes in registration fees. The Government's ongoing assault on third level students and their families has meant and will mean a real struggle for students to stay on and graduate from college. If we add to this the difficulties of people who have been denied access to further education because of under-funding of students returning to education and postgraduate students, we can correctly measure the Government's commitment to the knowledge economy and economic recovery.

I also note the Government is to cut social welfare payments to people who take up FÁS courses and that will end the long-term unemployment bonus paid to FÁS, VTOS and YouthReach participants. That is hardly progressive and hardly the stuff of encouraging people into education or, dare I say it, into work.

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