Arthur Spring (Kerry North-West Limerick, Labour) | Oireachtas source

I thank the Whip's office for giving me an opportunity to speak to the Bill. I am very much in favour of advancing anything to do with general practitioners. As I come from a household in which my mother was a nurse and my father, a GP, I understand the role played by the GP in society. I am very much of the opinion that in an advanced society people should have access to medical care.

One of the cohorts of people who need access to medical care more than anyone else is the elderly owing to the ailments that go with age. I welcome the provisions included in the Bill for the over-70s. A basic GP service should ensure people will feel free to go to a doctor and seek peace of mind that their ailments can be treated accordingly and that they can be sent in the right direction if there is something wrong. This also gives us an opportunity to welcome the provision of GP cards for children under six years of age. The Minister for Health, Deputy Leo Varadkar, is present in the House. The previous Minister, Deputy James Reilly, was also an advocate of free GP care. Members of both Government parties espouse a policy of universal health care, which is a long-held belief within the Labour Party and Fine Gael has endorsed the same ideology. The intention is to introduce the system incrementally.

I had the privilege of living in Sweden at one stage. The capacity to access medical care there spurred my belief in the ideology of social democracy. A cap was placed on the amount any single individual would pay - the Swedish krona equivalent of approximately €100. People made a small contribution over the course of five to eight visits to their doctor, after which it was considered the medical condition warranted access to medical care on a continuous basis and they did not have to pay any more once the cap had been reached. The premise is that when a person pays a little towards the cost, he or she takes ownership of the process and also demands more of the service. However, people only access the system when they need it. The amount of money involved was not particularly onerous.

I have spoken to people about how medical practice in Ireland has changed in the past 20 years. There is a perception that sometimes people with medical cards routinely abuse the system of access to GPs and medical facilities.

There needs to be honesty and clarity but the abuse of the system needs to be eradicated. We have limited services and need to provide them in a way that is meaningful for the individual and for the GP whose time is needed by a wide cohort of people, particularly in areas that are geographically challenged. Some GPs say that medical practices are becoming unviable in areas where the State subsidy is not enough. I am sure the Minister is aware of this. I have met with individual GPs, with their new organisation and the IMO. We need to safeguard access to primary care in rural constituencies. In future areas of a 25 or 30 mile radius may not have GPs. That is daunting for citizens in those areas and for GPs who want to retire but feel they need to stay as long as possible to provide the services to these people.

I admire many aspects of this Bill, particularly the access to primary health care for people over the age of 70 and that their dependants can get a GP medical card. The financial parameters are quite generous, set at an income of €700 per week for a single person and for a married or cohabiting couple, or civil partners, the dependant over the age of 70 will qualify if their combined income does not exceed €1,400 per week.

I would like to see more compulsion for GP cards for children under the age of six. If in areas where GPs can have a monopoly of services they do not opt in it will cause people a great deal of hardship because they need access to a GP personally and will not want to take their kids to another place. As a father of two young children I can see the need for this. There is nothing more frightening for parents who are financially strapped than to need to access medical services for sick children. The generation having children now is the hardest hit by the economic downturn, being in negative equity and making mortgage repayments. Some live in apartments and aspire to progress to houses in the natural way for families. This is a way of giving them and their children a break.

This Bill, however, concerns people aged over 70. It is a step in the right direction. The Government will try to encompass all of society in the system over time. The role of GPs in society cannot be underestimated. The easiest way to get elected to Dáil Éireann is to be a GP. There are not too many people who give out about the medical profession because they need it when they are sick. There is nothing more salient to people’s being than their health. I admire the profession greatly for the services it provides. It is well remunerated but we must admire it. This is a good Bill. It represents an advance and I hope we can make further progress in this area.

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