Mattie McGrath (Tipperary South, Independent) | Oireachtas source

I am pleased to speak on the Bill. I thank Deputy Terence Flanagan and others for sharing time.

At the beginning of his contribution on the Bill last Thursday, the Minister took time to give a list of all the great things that he and his Department are doing, such as publishing reports on the establishment of hospital groups and on the future of smaller hospitals. He has appointed chairpersons for each of the seven groups and is currently in the process of appointing the chief executive officers. In March 2013, he published Healthy Ireland, a strategy for empowering people in Ireland to get healthier. However, if I took the time to list all the deficits in the HSE and in the Department I would need more than the ten minutes available to me. In the limited time at my disposal, I note the Minister is now speaking about 2019 for the full implementation of universal health insurance, as envisaged and espoused by him on many occasions. The problem is that it is not clear what the Minister has in mind given that we are still waiting for the publication of the White Paper on universal health insurance. We heard the rumblings from the Minister for Public Expenditure and Reform, Deputy Brendan Howlin, at the weekend, while on Monday morning I heard the Minister of State at the Department of Health, Deputy Alex White, on "Morning Ireland" speaking about a little charge. I do not have a fundamental issue with a small charge on medical cards as applied to prescriptions, for reasons the Minister will be aware of, being a doctor himself. However, let us be honest with the people if nothing else.

The Irish Medical Organisation, IMO, and other groups representing general practitioners are deeply unhappy with both the content of the draft contract drawn up by the Government and the proposed new service, and the insistence of the Department of Health that it will enter only into consultations and not negotiations on the issues. The Minister appears to have forgotten his past. He was on the other side negotiating on behalf of a certain group and he expected, demanded and got negotiating rights and, I might add, negotiated a very good deal for his own group at the time. It was a group that negotiated well and got plenty from people who were willing to give plenty at the time. We all thought we had plenty but we had not. Faraway cows have long horns.

Last week, the IMO warned that it would consider seeking an injunction to prevent the Government from introducing changes to the contracts of its members without agreement. That is what the Minister would have espoused when he was on that side, but he should not forget everything. I hope the Minister and the Department will be open to more constructive forms of dialogue on this matter and listen to the experience of general practitioners on the ground. My experience is that the vast majority, 99.9%, give a tremendous service. Their clinics are overrun because the hospitals cannot cope and people go to them when, on many occasions, they should be in hospital. Some people who visit the GP discover they do not have medical cards. At this stage the GP has to be a counsellor and deal with traumatic situations and has to engage and listen to people. Medical cards have been systematically removed from old and vulnerable people who have not been notified. They only learn this when they visit their GP.

I wish to challenge the Minister on one issue. I have seen in print that a person's medical card cannot be removed for a period of three months from the date of a letter from his or her doctor. Perhaps the Minister would respond to that issue and put the lie to that if it is untrue. Many old people are traumatised because of the situation. I have a regular flow of e-mails on the issue, including two yesterday from GPs in my constituency who said that GP visit cards had been removed without notice even though they were not due to expire until 2017. Such action is faceless, cold, bureaucratic and shows no sensitivity. The way the system deals with it is outrageous.

I have been in regular contact with local GPs who are deeply concerned about the proposed changes to the system, especially the proposal for free GP care under-fives. This will be a banana-skin issue because the Minister will slip on it and will fall and will need medical treatment. I do not wish the Minister any ill, but that could happen. This is a real sickener for hundreds of people. At least 20 people per day contact my office about the removal of medical cards and the Minister is talking about giving them to under-fives who, thankfully, normally are quite healthy.

He will flood GP clinics with people who thought they were healthy until last weekend when the Minister for Public Expenditure and Reform, Deputy Howlin, put his oar in. Thankfully someone can talk sense to the Minister for Health who is not a good listener and say they will not provide the money for the Minister. That is the only way to deal with him, turn off the tap. Then he will not be able to go ahead with his crazy plan to give it to the under-fives and take it away from cancer patients and patients in all kinds of situation. This has to be visible to the Minister unless he lives in a bunker. This is happening up and down the country. Sick people are traumatised and devastated. A man rang me today who has been waiting months for his medical card. He is a cancer patient who is unemployed and receiving social welfare. The hospital demanded €75 from him. He rang me from the hospital to know what is the situation regarding his card. That is a sad, desperate situation. The Minister talks poppycock about introducing free GP care for under-fives or under-sixes as a first step on a ladder that is going nowhere. It is a ladder that will fall as soon as it is erected because it is standing on ice and will fall through the cracks when the Ministers for Public Expenditure and Reform and Finance pull away the funding.

We were disappointed when we heard that our hospital was being disenfranchised from the South East region which we had been part of for years but vested interests in Kilkenny and elsewhere wanted to link up with Dublin and left us high and dry. Thankfully, our hospital is now aligned with Cork University Hospital. That is all that has happened. The Minister has appointed chief executive officers for those regions but nothing else. We are in Limbo.

There are many good outcomes in my local hospital. Front-line staff, from those at the front door all the way up to the consultants do an enormous job in terrible circumstances. The Minister has only once visited that hospital, to launch a learning programme with Limerick University. He did a quick tour of the hospital. He ran out of it quicker than Cromwell fled from Clonmel. He was to meet us Oireachtas Members-----

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