Jerry Buttimer (Cork South Central, Fine Gael) | Oireachtas source

We all recognise that medical cards are of extreme importance. They represent a very important social support that is supposed to provide access for those who cannot otherwise afford their required medical care. We must always remember that the primary purpose of medical cards is to support the patient. This focus on patients and their needs sometimes gets lost in the political infighting and in the system.

Everyone in this House is aware of very difficult stories of people who are just over the income limits and people who are over the income limits and have certain medical conditions, but cannot get a medical card. There are heart-breaking stories that all of us in this House can share. In saying that we, as politicians, have an obligation to reflect on the system and how we can make it better on behalf of the patient.

When people get letters stating their medical cards are being reviewed, it causes distress even if it is only a simple review process. For some people these letters translate to "they are trying to take away my medical card" or "I've lost my medical card". Thankfully, in 93% of cases this does not happen. However, sometimes those working in the system processing the medical cards do not realise the impact their letters have on the individuals and their families.

Tomorrow the members of the Joint Committee on Health and Children will travel to Finglas to visit the PCRS. We will highlight with the staff and management at the centre the personal impact of how the system affects the patient. I pay tribute to the staff at PCRS for the work they do as public servants.

While I accept there are difficulties in the health system, we must also recognise that in the past three years improvements also have been made, although these were not alluded to in the motion before us tonight. These improvements are down to the reforming Ministers and the hard work and dedication of staff in the health service.

At the peak of the boom and the beginning of the bust, adjusting for our very young population, Ireland had one of the most expensive health systems in the world. Since the Government came to power it has managed to do what Fianna Fáil failed to do - none of its Members is present in the House which shows their dedication to the health system - it has increased services even as it has cut costs. Hospital budgets have been reduced by 11% since 2009 while the number of people treated has increased by almost 13%. This is equivalent to a 24% productivity improvement. However, this is not about productivity but about the quality of the staff in our services. The number of people waiting on trolleys in 2013 was a third lower than in 2011 when those numbers were chronically high and this year already there has been a 9% reduction compared with last year.

The Government's reform programme can and will do even more to make the system more efficient. However, as a Member of the Dáil and a public representative, I am becoming increasingly uncomfortable about the level of savings being demanded in the health area. There seems to be a view among some that health is some kind of public sector ATM and if one just presses the right buttons, it can continue to deliver cash savings. The bottom line is that we have an ageing population and demand is growing. We cannot keep asking the men and women who work in the health system or the citizens who depend on the services that they deliver to keep taking a financial hit in the health area. It is not fair and it is completely unrealistic. I hope that in the wider health debate leading to UHI we will recognise that health services are demand led and are about people.

If we want a medical card system that does not operate on the basis of who one knows, as it was in the past, but functions based on the needs of people, we must change the legislation and change our approach to health which the Government is doing in regard to UHI. We must have in place regulations that allow the officials to make appropriate decisions so that we can meet the health requirements of those most in need in a way that is humane, full of empathy and that recognises there are people whose medical conditions deserve the medical card and the long-term illness scheme.

I challenge the Sinn Féin Members opposite. Their motion did not outline their solution and the way forward. They need to put the meat on the bones of their motion. They should not just play politics and go for populism. They must show us what is their policy by revealing their hand. I respect Deputy Ó Caoláin as a valued member of the Joint Committee on Health and Children. I call on him and his colleagues to attach to their motion the substance of what their health policy is because talk is cheap and they have done a lot of that in recent weeks.

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