Finian McGrath (Dublin North Central, Independent) | Oireachtas source

I welcome that. I had intended to raise their case because we have talked to the GPs and understand their situation. It is very difficult. We do not wish to lose high-quality people so we must ensure they are supported. We understand the costs they have in terms of administration and so forth. When I visit my GP, his clinic sometimes resembles the very busy clinic of a backbench Deputy. With so many people there is stress, and the staff are under pressure too.

Under this scheme, approximately 240,000 children - that is, 57% of children under six - will gain entitlement to free GP care that they did not have previously. A total of 420,000 children aged five years and younger will be eligible under this scheme. Within that number, 181,000 - 43% - will retain the eligibility they currently have for GP care under a medical card or GP card. These figures reflect the number of children aged under six in the last census in 2011, which is 420,745. However, we will have to be prepared, because the Central Statistics Office, CSO, has projected that by 2014 the population of this age group will have increased to between 441,907 and 443,133, which suggests there will be a little over 20,000 more children aged under six years in the State than the figures quoted. We must be constantly vigilant about the numbers because we have a rapidly growing population. This is also having an impact in our primary schools, particularly on the junior infant classes.

I mentioned the high cost of GP visits. Currently, GPs earn income by way of fees from their private patients, which are approximately 60% of the population, and providing services to public patients under the GMS scheme, which covers medical cards, GP visit cards and other free-at-the-point-of-use services such as immunisation and screening. The IMO has argued that the GMS scheme is designed to protect the poorest and most vulnerable in society and that it believes the integrity of the scheme is lost in this proposal. This was said in a debate that was held earlier. The Society of St. Vincent de Paul was also worried and said we must target people on low incomes and people with particular needs. That fits into the points I made earlier. We must ensure that the poorer and weaker sections of society are not forgotten in this broader debate.

Another issue arose recently. I do not know if the Minister saw "The Saturday Night Show" with Brendan O'Connor which featured Declan Coyle and his family. His son Alex, whose medical card has been axed by the HSE, was brought into the studio. He requires a cocktail of syringes, feeding pumps, nappies and medication. All of his issues were related to us. We cannot allow situations such as these to arise. It should be about medical need, the rights of the children, protecting their health and supporting their families.

Overall, I welcome the legislation. I will always support reforms that are sensible and I will always support a health service that is based on equality and respect for the citizens of this State. If we are serious about building a new republic, and there is cross-party consensus on this, people must accept that changes must be made. We cannot return to the ways of the past. We can use this opportunity of reorganising the country and the public finances to start afresh. Many other countries have done that in the past. There is no reason we cannot start to build from the mess of the banking crisis of the last number of years, the evolution of the international financial crisis and the rampant greed that was in our society for many years. We can all learn and make a start. We can start through small measures such as this legislative measure. That is one part of it, but we must also be very realistic and sensible. If every person in this State pays their few bob and their tax for the health service, they are entitled to a health service.

Equally, there is the issue of those who work in the public service and the health service. The vast majority are doing a fantastic job, sometimes against the odds. However, we must ensure that standards and professionalism are always maintained, and there have been many cases in which families have been let down. All of us must constantly up our game. That is what public service is about. It is amazing that we are losing many good nurses and medical personnel. They train and go to college here - we spend millions on them every year - but then leave within two or three years. We must stop that brain drain, particularly in the medical services. Those young people are the future of the health service.

Legislation such as this can assist young children, but it can also kick-start the fulfilment of a broader vision of a health service that looks after its patients and makes top-quality health care the priority.

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