Mattie McGrath (Tipperary South, Independent) | Oireachtas source

I too am delighted to speak on this Bill. We hear about targeting resources rather than giving them to people over the age of 70 who can afford to pay. I remember the march on Leinster House, the anger and the anguish, when the last Government removed the medical cards for people over the age of 70, and the promises made from the back of a lorry outside the House by senior members of Fine Gael and others. If that was not playing politics with it I do not know what it was. Nonetheless they got what they wanted: they got into government. We have a relatively new Minister now and I wish him well. I am glad he is here today for the debate. There are many issues and he should know more about them than I do because he is a medical practitioner.

I never agreed that everybody should be entitled to GP visit cards or medical cards. Michael O’Leary has said this and there are others like him who are wealthy and do not need medical cards. I do not understand why our system is not efficient enough to deal with that. I do not accept it is too difficult and costly because with specialised information technology today we should be able to distinguish between people and not waste scarce resources on people who do not need them and have said they do not want them. The Government could ask them to give them up.

The free GP card is for those over the age of 70 but their dependants, spouses and partners under the age of 70 will continue to be means tested in order to have free access to their GPs. How is that fair? The spouse aged 69 or 68 and a half, might not be in the best of health while the person over the age of 70 might be in excellent health. That is farcical.

Section 2 amends section 58 of the Health Act 1970 to remove all individuals over 70 years of age from the scope of a means-tested service based on holding a medical card or GP visit card. Instead, all persons over 70 years of age will automatically qualify for a GP service and it will not be necessary to hold a means test for a medical or GP visit card. Since that famous march, the withdrawal of the cards and the recession, many sick people and their families, if they are lucky enough to have families, who have been waiting a long time for cards, have come to my clinic. They are cancer patients and people with other disabling conditions and the stress and trauma of dealing with forms and sending more and more information has been enough to make them sick. When one is seriously ill, young or old, one does not need other stresses. One needs to be able to receive treatment and try to maintain a stable condition mentally and physically, to the best of one’s ability. My office has been inundated with horrific stories. I am no different from any other public representative in this respect.

The pet child of the former Minister for Health, Deputy Reilly, was free GP care for children under the age of six. I have eight children and often in the cycle had three under the age of six. They were normally pretty healthy, thank God, and did not have serious illnesses. We were blessed in that respect. A five year old who has a serious diagnosis, a disability, or some staggering disease will not have the free care when he or she turns six. It is nonsense. New diagnoses and treatments have turned up and people have lobbied and had to go the National Health Service, NHS, in the United Kingdom, but those treatments are now being provided here, after a battle. The free care should be available to all or none, instead of discriminating on the basis of age.

I know we cannot have a panacea for everybody but we need to improve the health services. Good work is being done. I returned ten minutes ago from the Mater Private Hospital. Appointments are kept there without queues of people on trolleys. It useful to see how a private institution can be run. I do not know about its profitability but it is run efficiently. I have been there several times. I left here at 2.30 p.m. and am back with my procedure completed. That is how the service should be run. I have spoken to the Minister about this. He set up a so-called dynamic team to deal with the trolley crisis but I believe the wrong people were on it. Consultants, GPs and unions were represented on it. Certainly they have to negotiate but not on the strategic committee. It should involve front-line managers. The Minister told me Grace Rothwell from South Tipperary General Hospital was on it. There could not be a better person on it. That is the sort of person the Minister needs, not the vested interests. I am surprised at the Minister for allowing that to happen. Front-line managers and workers are the only people who know how to clear the backlog.

Hospital rounds should be changed to much earlier in the mornings in order to free up beds.

A relative of a patient in Cork University Hospital contacted me last week because ten days after finishing his treatment he could not get home. There was no taxi service. If they used an ambulance to bring him home they would have a free bed. I could not understand the logic of waiting ten days to get home. I contacted the manager in South Tipperary but she said it was a matter for Cork University Hospital, and rightly so, but there should be joined-up thinking. A person should not be waiting for ten days to get transport home. That is totally farcical. I see that the Minister, Deputy Fitzgerald, looked at the Minister, Deputy Varadlar, as if to say "Is that fellow raving again?", but I am not. I can give the Minister the details but it should not be happening. I have the details on my email database and the reply as well.

We have seen the situation concerning GPs in Tipperary. I attended a public meeting 18 months ago and we saw an excellent GP, Dr. Paddy Davern in Tipperary town, who is now in Doha or Saudi Arabia. His wife is a nurse and they have a young family. He was a very good doctor with some specialties and had a great practice but he could not make it viable. The Minister knows as well as I do that GPs are under siege. During the health crisis people were discharged quickly when Trolley Watch announced figures in our hospital in South Tipperary. That was the answer to get rid of those waiting lists, but people were being sent home too early. As a result, that night they were looking for Caredoc or were in the GP's surgery the next morning. The Minister is creating the backlog, pushing people back and forth, but they are not being serviced.

Some great treatments happened in South Tipperary General Hospital and I want to praise the management and staff there and in other hospitals too. Once a person gets into the system some excellent treatments are carried out with good recovery rates and compassionate care, which is what it is all about. However, we need to have some kind of sensible management. Front-line staff must be supported but we should get rid of about four layers of middle management. When the health boards were amalgamated we were told it would be like manna from heaven. The former Taoiseach, Bertie Ahern, said he was going to disband them and the former Minister for Health, Deputy Brian Cowen, may have said something similar. They have not been disbanded, however, and even if they were, nobody lost any positions. There were no job losses, so that is where the fat is.

I am tired of saying it. When matrons ran the hospitals there was no RSA and various other bad conditions. We now have a plethora of mangers in charge of beds, wards, floors, hygiene and day therapy. They are going around with flip charts to conferences and having case meetings about things. It is a joke.

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