Alex White (Dublin South, Labour) | Oireachtas source

It may not be, but we cannot just operate on the basis of what is popular. We have to press ahead all of the time. Sometimes what we have to do in politics is make small incremental changes and that is certainly what I am dedicated to doing.

I refer to my responsibility for primary care services. The House will appreciate that, in common with health systems throughout the world, the Government is addressing new serious challenges such as ageing populations and the creeping epidemic of chronic illness. Health care must become the concern of the whole society, not just those who are ill or those who care for them, important and all as that is. It must literally be about health, not just about illness. It must be about staying healthy, not becoming sick. Health policy must be about nutrition, fitness, exercise, addressing lifestyle factors such as smoking and the excessive consumption of alcohol, what we eat and how we live our lives, taking control of and managing our own health. It is in that context that the Government is bringing forward our policy of universal access to primary care, an absolutely essential component of what we are doing in the area of health. The budget announcement is being brought forward in the form of legislation to extend access to GP care to children under six years of age. I am happy to be able to indicate that I expect that legislation to be ready for introduction in the House within one month.

The Government is providing additional funding of €37 million to meet the cost of this measure. A draft contract for the provision of services for children aged under six years was opened up to public consultation last month. I am very keen to hear the views of general practitioners, in particular, and their representative bodies on the content and scope of this draft contract and have communicated this to them. I emphasise, as I have done in correspondence with the representative bodies, that the Department and the HSE are fully prepared to engage meaningfully with GP stakeholders. I am prepared to negotiate with the representatives bodies on all aspects of the scope and content of the proposed contract. While the ultimate setting of fees must remain a matter for the Minister for Health, there will be a real opportunity for GP input on this aspect and the fee structure which it is proposed will be addressed in a separate consultation process.

The extension of free GP care to all children under six years of age is the first phase in the introduction of free GP care to the entire population, as committed to in the programme for Government. A range of options for a universal GP service is under consideration with a view to bringing developed proposals by way of a memorandum to the Government within a short period.

The House will be aware that the Government has embarked on a major reform programme for the health system, the aim of which is to deliver a single tier health service supported by UHI where there is fair access to services based on need rather than ability to pay. This is a hugely important area of public policy in which all Members should involve themselves. I would like to see us agitating as much for improvements in primary care as some of us did in regard to hospitals or particular facilities in the past. Hospitals are important, whether in the community or at national level, but most important of all is primary care. To the extent that the politics of health care have just been about saving hospitals, I urge colleagues - I am not seeking to engage in an argument with any Member or on any issue in various parts of the country - to turn their faces towards genuine reform of the health service. This has a lot to do with enhancing and resourcing primary care services. We must fight for these resources. That is the objective of the Government; certainly it is my objective and preoccupation at this time. I look forward to engaging with the House again on the issue.

See this speech in context