Micheál Martin (Cork South Central, Fianna Fail) | Oireachtas source

This measure will affect 90% of health insurance plans, not just the gold-plated ones. That sleight-of-hand in the presentation of the measure is to be regretted. There is too much of this in today's presentation, a matter I will deal with more comprehensively in my contribution tomorrow. The presentation of many of the measures announced left a lot to be desired. This measure suggests an incoherence at the centre of health policy. The Government has a policy of encouraging more people to take out health insurance and of having mandatory health insurance by means of a universal health insurance policy - the detail or execution of which is further away by the day - while at the same time an extraordinary scale of cuts have been imposed on the public service, with approximately €660 million worth of cuts. The estimated saving is an additional €127 million in a full year from this measure. In total there will be approximately €787 million in savings overall in health care. I do not know what the Minister for Health, Deputy James Reilly, was doing during the negotiations and the talks leading to this budget; he must have been asleep at the wheel or not engaged in any way. Does he realise what has happened under his watch in this budget as opposed to other Departments? I agree with Deputy Róisín Shortall's apt phrase that the centre simply cannot hold in the health service. Last week we raised the issue of discretionary medical cards and were told we were not dealing with reality. Within four days the Taoiseach had acknowledged it when members of the Fine Gael Party had informed him that people all over the country were losing their discretionary medical cards. Some of the cases are horrendous, such as those involving children with multiple conditions and syndromes being refused cards. People with motor neurone disease are also having their medical cards taken from them. What does today's statement about saving €113 million and probity mean? Is that a transparent presentation of a budgetary measure? When one includes the over 70s, the guts of €150 million are being taken out of the provision of medical cards. There is an absence of detail in the presentation of the measure.

Hospital surgeries are being cancelled because they are running out of money. Hospital procedures are being delayed and cancelled because funds are running out. We need a far more transparent debate about how health services are to be funded into the future and less of this codswallop about universal health insurance and money following the patient. There is no detail attached and no White Paper has been published. Deputy Róisin Shortall was in the Department and has given us the most up-to-date account of the absolute divergence between what is contained in the programme for Government and what is happening in reality. This measure will affect ordinary families. A total of 90% of health insurance plans will be affected and the measure hits hard-working families who are endeavouring to supplement and complement what they can obtain from the public service.

Will the Minister confirm that the chief executive officer of the HSE stands over the figure of €660 million, as presented in today's Budget Statement? I presume he does. It is a pity the Minister is not present to confirm this. Will he also confirm that the Secretary General of the Department of Health stands over the figure of €660 million? Will he confirm that each figure identified in the budget documentation which represents a saving measure can be backed up with the detail one would normally receive in the more traditional Estimates volume but which is in short supply in the documentation we have received to date?

It should be remembered that this all stemmed from a commitment that those with a long-term illness would receive medical cards. That promise has been solemnly discarded and broken, with no explanation or presentation of any legal opinion which has now entered the scene to provide a reason this measure cannot proceed. Those most in need because of medical conditions have most to fear in terms of what will happen next year in respect of medical card eligibility and access to private health insurance. As Deputy Billy Kelleher noted, many people with complex conditions require good packages. It is about more than medicines and prescriptions; it has to do with a range of other measures. The people concerned will be hit hardest by this measure which flies in the face of the Government's stated objective of getting more people into the health insurance sector. Thousands of people have left the health insurance market in recent years, leaving in their droves because of escalating costs. This action will exacerbate the drift from medical insurance policies which we have witnessed. It is incomprehensible and represents incoherence at the heart of health policy and decision making.

See this speech in context