Catherine Murphy (Kildare North, Independent) | Oireachtas source

In principle, I support the idea of universal health care as a positive element in society, but I feel that inadequate consideration has been given to the practical consequences. The incremental measure will lead to a decline in the quality of health care for many people. I look at the practical side of this. If one is going to deliver a measure such as this, one needs to do it in co-operation with those who will deliver the service. When we talk about free GP care, I look at some of the most basic care, such as that provided by the public health nurse to new infants in development checks. Some of these have been dispensed with, because there is inadequate cover with regard to that side of things. It shows how threadbare our primary health care service really is. We run the risk of making GPs into bureaucrats and of having very long delays for people who require an immediate visit to a GP but who will have to make appointments days in advance, as is the case in some parts of the UK.

I would have liked to have seen an impact analysis in advance of this legislation so that we could have some understanding of how it will pan out. I would like to see the service provided to children under six, but I would have thought that if one was looking at the pecking order of need, one would have looked first at those who are sick or who have disabilities - the cohort of people who would have had an expectation of medical cards. I think the Government had set this out as their expectation for the roll-out. I do not know why this criterion or intention was changed.

We are certainly turning doctors into bureaucrats. I have ongoing dialogue with the local GPs in my area, who are constantly going to and fro. We are asking them to fill out forms for discretionary medical cards, which is time they should be using to deal with the health needs of people who turn up at their practices rather than administrative needs of the HSE. I know the IMO is a vested interest, but it is also quite expert in this area. It is extraordinarily critical of this Bill and has pointed out that if introduced, it would certainly lead to an increased workload in clinics and a need for additional resources. Has this point been considered? At the very least, it should be considered. If it is not valid, I will accept it, but there may be some validity in what the IMO is saying and, at the very least, it needs thorough consideration.

The point has been made by GPs that it is not enough to simply introduce free health care for those under six. What we need is a preventative health care plan for each child. An interesting fact I come across, as I am sure most other Deputies do, is that when a child receives an early diagnosis, very often he or she ends up on a very long list even for fairly minor procedures such as a tonsillectomy. I was told that the waiting list in Tallaght is two years and that one might be better off advising people to go back to the GP and see if another hospital can accommodate them.

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