Clare Daly (Dublin North, Socialist Party) | Oireachtas source

The right to health is one of the most basic human rights that any citizen would aspire to. Our ability to access it is far too tied up with our ability to pay and the amount of money we have in our pockets. I have just come from a heart-breaking press conference of parents of much wanted children who were diagnosed with a fatal foetal abnormality. This afternoon they launched their petition to the United Nations regarding a violation of their human rights in this regard. One of the women, whose little girl was born in the summer with a number of serious health problems that require ongoing care and attention, made the point to me that in recent days they were denied access to a medical card. When people are already struggling to care for themselves and their loved ones, the idea of being dragged back down by financial considerations or bureaucracy is abhorrent in anything that would claim to be a civilised society.

In his opening remarks this morning, the Minister made the point that nobody, who is entitled to a medical card, will lose out by the changes in the legislation before us. I reject that way of putting things because it is possible to change the rules on anything to change people's entitlement. An entitlement is something in some ways that can be spun as being very different from saying that everybody who needs it will get it. Our starting point should be need rather than entitlement because entitlement introduces a certain element of an insult that some are entitled and others are not. Somebody who needs medical care should be entitled to access it regardless of financial means.

The problem here is that the goalposts are moving all the time. This legislation proposes to reduce the gross income ceiling for over 70s to get a medical card from €600 to €500 a week for a single person. It was previously €700 and in effect we are discussing the cumulative impact of a reduction of almost 30% in the past two years. As Deputy Tom Fleming stated, it is even worse for couples as they are experiencing a reduction of 35.71% over the two years. I believe the Minister has a social obligation to address the anomaly in this discrimination affecting couples. In any other scenario a couple is taking as being double the income of a single person.

However, not content with that in this scenario, the Government has reduced it to €900. Had it been double the single-person allowance as every other social welfare payment is and had the bar been set at €1,000, some people have informed me that they would still be able to access a medical card, but because of this sneaky manoeuvre they will lose out now. I know of at least one couple in my area and the wife in the relationship has a serious lifelong medical condition. They will not be able to access the medical care she needs through the GP and the medical card. She will probably end up in hospital and be a much more serious drain on the State.

What we are doing here is somewhat like our pension system and goes against the entire ethos of what the Government claims it is trying to do in terms of access to health care. The idea of universal payments is far more administratively efficient and far more equitable. When people are working and earning big money in their early or middle years, they should be taxed on that income. However, all citizens should be entitled to access medical care when they reach old age.

It is clear that this measure is designed to remove many people from that loop. We need to see it in the context of the living standards of pensioners. Much has been said about how they have not really been touched up to now, an analysis for which there is no backup. For 80% of our pensioners, the majority of their income comes from the State pension. That is a phenomenal figure. It is a very limited amount of money. When one gets to that age, one might not have a mortgage so one's outgoings are somewhat smaller, although many pensioners are obviously subbing their sons and daughters who cannot make ends meet. They are not living the high life by any means. Apart from an individual cost to the citizens, it will make people more cautious about their health care, leading them to slow down on measures that could get them an early intervention. It is inevitable that this will cost the State more in the long run. We are contributing to the undervaluing of elderly or retired citizens, which is a disgrace.

Other Deputies have highlighted the fact that regulations regarding gross income do not take into account the cost of those with special health needs and all the extra costs that go with managing particular health conditions, be it increased heating at home or the need to buy special food or maintain special medical equipment. We must see it alongside the other cutbacks like the second increase in the prescription charge from €1.50 to €2.50. It is just not good enough that the Minister for Health can say "vote for me and I'll abolish prescription charges" when he is an Opposition spokesperson and then increase them, not just once but twice, when he comes to power. This is an absolute betrayal of the electorate.

Medical cards are not a handout. The medical card is a benefit that was fought for and paid for by workers through the PAYE and PRSI they paid during their working lives. Withdrawing it at a time in their lives when they are most likely to need it is roundabout economics. In essence, it is an attempt to scapegoat elderly citizens as if they were the ones who caused the crisis because this is all about saving a few bob at their expense. When one considers the measures the Government failed to implement that would have allowed it to generate a considerable amount of extra taxation such as implementing a wealth tax, dealing with the issues of corporation tax and increasing the amounts of income tax on those earning six figure salaries, one can see that all of them would have enabled it to generate extra revenue. Instead, this Bill goes for the soft touch and will have an impact on well over 100,000 people in the community. Apart from prescription charges and other cutbacks, we need to look at the cutbacks in home help hours. We have short-term austerity measures that will cost society far more in the long term because we are not going to grant this concession.

I will deal briefly with the issues highlighted by many organisations that deal primarily with care for older citizens. In particular, Age Action Ireland has played an invaluable role in that regard. It has paid particular attention not just to this measure but to the cumulative and multiplier effect of rising costs and undermining health services as a combined product of the years of austerity and the financial pressure put on people. It must be seen in that context. Anne Dempsey from Age Action Ireland has said that "the ability to phone family and friends is an important link". She has also said that "this cut will drive people into further isolation, will contribute to greater stress on our health services and will ultimately cost more money than it will save". According to the second edition of Social Determinants of Health: The Solid Facts, published by the World Health Organization, "the longer people live in stressful economic and social circumstances, the greater the physiological wear and tear they suffer, and the less likely they are to enjoy a healthy old age". As one ages, the risks of health problems increases. The key issue here is that prevention is better than cure.

All of the measures we can put in place as a civilised society to raise the living standards of elderly citizens and allow them to access medical care when they need it, regardless of their ability to pay, not only deliver a healthier population but also save society far more money in the long run. To me, the Minister has got things completely the wrong way around. This is an austerity measure targeting the most vulnerable and will cost society in the long term.

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