Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

That is welcome. I have pages of information highlighting many cases which have been highlighted for me in the past two years and more to do with discretionary medical cards. The details of these cases have been forwarded to the Taoiseach and the Minister of State's office. The policy on discretionary medical cards must be addressed and I hope it will be. There is a window of opportunity before Committee Stage to do this. I believe the Bill will now be taken on Committee Stage a week later than originally intended and hope something will be done between now and then to address the issue.

On health services in general, we cannot take one area in isolation. The Department has a defined amount of money to spend each year and must prioritise and make choices. I accept this, but some of the choices made and priorities set should be revisited. Dealing with the issue of discretionary medical cards is an obvious priority. The Department also needs to refocus the funding streams from the acute hospital setting to the primary care setting. If it makes economic sense to treat patients in the primary care setting, it should be a priority for the Department which has a certain amount of money to spend to transfer the spending from the acute hospital setting to the primary care setting. We have all bought into the primary care strategy published some years ago, but we need to look at it again to determine how we can deliver primary care more quickly and with more determination.

We have spent more time in this House talking about where the Minister should locate primary care centres than about the primary care system in general. This is an issue I have not yet got to the bottom of and it is another day's work.

I do not ever expect to get to the bottom of how they define the locations for primary care centres given that I have tried and failed. However, we live in hope on that issue.

Some interesting figures have come out on waiting times. We now have a major concern that waiting times are creeping up rapidly and the numbers of people waiting are also creeping up. The number of people who have been waiting for a year or more to be seen as outpatients has increased from 4,000 at the end of last year to more than 14,700. The outpatients figure is quite alarming even though the Minister, Deputy Reilly, has said on numerous occasions that it is not a major issue of concern - I do not mean by this that he is not concerned about it. He said it would be easily resolved because approximately 250,000 outpatients a month are seen. However, the figure is now moving rapidly in the wrong direction and that area needs to be looked at quickly.

While the Minister of State talks about the successes and I try to make proposals from time to time that might be considered, I would be failing in my duty as an Opposition spokesperson if I did not also highlight the failings. The area of waiting lists needs to be looked at very quickly or else there will be grave difficulty very soon with regard to the numbers of people waiting for outpatient, inpatient or consultant appointments. That is happening as we speak. When we consider the acute hospital budget overrun for the first three months of this year, the Government will find itself with a major problem at the tail end of the year and that needs to be addressed.

I will not oppose the Bill on Second Stage. I have grave reservations because it prioritises healthy and wealthy children over those who need the service more than ever. That has been happening for the past two years. I believe the budget ring-fenced €37 million for GP-visit cards for those aged five and under. However, when one builds a fence one can keep people out with the fence or keep people in. The ring-fencing of the €37 million has taken €37 million away from those who need it more at present. I hope I will be able to support the Bill on Report and Final Stages because the Government will have added the measures, with which I will try to assist it, on Committee Stage to ensure that people who need the support of the State because they are exceptionally ill or dying will get it first and foremost. We need to introduce an element of fairness, humanity and compassion into the system of how we assess people for the provision of medical care.

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