Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance) | Oireachtas source

I will take up where Deputy Murphy left off. I am in favour of universal access to health care. The repeated emphasis in the Minister of State's introductory speech and the Government's setting out of its vision to develop the health service is on the need for universality in access to health care. The removal of user fees from any group is to be welcomed. I believe that user fees for health services are unacceptable, obnoxious and wasteful. There are a myriad of reasons why we need to remove them but, as has been said by Deputy Murphy and generally over the past while, the perfectly understandable perception is that we are giving free GP care to the under-sixes at the expense of other groups of chronically ill, disabled or elderly people with serious medical needs. The perception is that this is the quid pro quo. That is unacceptable. The Minister of State will say that this is not the case and that additional money is being provided.

We heard on Sean O'Rourke's show again this morning about the appalling and most impossible circumstances of families with severely disabled children who were being denied medical cards. It might have been related to the family to which Deputy Catherine Murphy referred. This week an elderly lady came to my clinic who could barely breathe. I could hear that she had an inability to breathe. She had a severe, chronic, permanent pulmonary condition and was wheezing constantly during our conversation. She informed me that her medical card had been withdrawn and that she had to reduce by half the medication she took, although she might literally collapse and die, of which she was fearful. She feared going up the stairs or going out for a walk. She could barely breathe, yet her medical card had been removed following a review. This is absolutely unacceptable.

Understandably, people ask how the Government could possibly endanger the lives, health and welfare of severely sick, disabled and elderly people, while at the same time giving free access to health care to children whose families may well have sufficient resources to pay for it. As a supporter of universal access to health care, I do not accept the setting off of one against the other and do not want to go down that road. It is absolutely understandable people are asking what the hell the Government is doing when they see medical cards being taken from chronically sick and disabled people. It is difficult not to conclude it is a political stunt.

I want to see universal access. We are not going to oppose this measure, but we are against the slashing of health budgets and what was referred to in euphemistic jargon, to cover over budgetary cuts, as "medical card probity". I love such phrases. In this case, probity means savage cuts affecting the disabled, the sick and the vulnerable. That is what probity turned out to be, as predicted by us when the measure was included in the budget. That is the current position.

The Government must do something to ensure the two sides are not set against each other. Young children should have access to whatever health care they need. I applaud and concur completely with the idea that we need to move towards preventive health care and what is proposed is a step in that direction. If we ensure children are healthy from a young age and give them the access to the health care they need, it will pay off and pay dividends further down the line, but this cannot be achieved where the policy is set against the literal endangerment of the lives of some of the most vulnerable, the ill, the elderly and disabled people. That is appalling and unacceptable.

Deputy Catherine Murphy's point is well worth underlining in the light of the example I gave of the lady who came to my clinic this week. Ultimately, there may be no savings, as the Deputy said. The lady who came to my clinic literally looked like she could collapse at any time. If she collapses, she will end up in an accident and emergency unit. This will cost more than it would if we were to give her the medication she needs by returning her medical card. What is occurring does not make sense and I seriously hope the Government will address that appalling set of circumstances.

Everybody deserves health care when he or she needs it. We need to allow for universal access that is free at the point of need. Nothing is free in this world; it is always paid for, but it is a question of whether we pay in a fair way through central taxation. This is linked with ability to pay and is thus fair and progressive. It is critical that people receive the health care they need when they need it.

Let me outline where I am critical of the particular model of universality in question. I have made the point on a number of occasions, including to the Minister, Deputy James Reilly, that linking universality with a plan to involve private health insurance companies is inappropriate. Putting the money into the pockets of private health insurance companies is sucking out resources that should be going into front-line services and contributing to the required staffing levels, health care, the recruitment of doctors and nurses, etc. I do not see why we need these companies or what value they add to the process. I have not heard any justification for their involvement in it.

The examples of Holland and the United States were raised by us on a number of occasions. I refer to the so-called Dutch model and the US model. As I pointed out on a number of occasions, the United States spends more, proportionately, on health than any other country, but 40% of that expenditure is on administration linked with private health insurance companies. It is utter waste. The money is spent on advertising, billing and all that unnecessary crap, including paying the massive and inflated salaries of the top executives in the health insurance companies. Why do we need them? We do not. Why are they involved? They should not be. They are profiting from health care and the health needs of ordinary people. It is all the same, whether the money spent in this way is sucked out of the pockets of citizens through inflated health insurance costs or the public purse. They are equally bad. It is money down the drain and a complete waste. What we need is a national health service and free access to health care at all levels, from the cradle to the grave, provided by a public health service funded through central taxation. This would remove all the waste and the middleman who is sucking out the money.

The Government needs to address the concerns of general practitioners. I am glad that there has been some agreement, but the case general practitioners made to us at the meeting in the Burlington was pretty scary. They were saying they were leaving; some had actually bought their tickets to go on the grounds that they were in an unsustainable position. Unless we get them on board, this will not work.

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