Fergus O'Dowd (Louth, Fine Gael) | Oireachtas source

I welcome the changes made in this Bill. I listened carefully to what my colleagues opposite said. The fact remains that everybody should get the medical care they need at the point they need it, regardless of income and family circumstances. There is a progressive taxation system in this country where the more one earns, the more one pays. Nevertheless, as has been pointed out, a significant number of people are paying for private health insurance. Whether we are getting value for money or not, the more competition there is in the marketplace, the more companies will enter and offer choices to patients at different stages.

People seek medical help and attention at an acute point in their life cycle, such as when they are seriously ill, have to go into hospital or into a nursing home when they can no longer continue living at home. We need to examine not just health insurance issues in these cases. It would be far cheaper on the State to invest in continuing care in the home so as to keep people in their homes as long as possible. The first option on the fair deal scheme is to go into a nursing home when it should be the last.

I welcome the increased packages of home help care and other support services provided by the Minister. However, they do not go anywhere near far enough. As our financial position improves, I would welcome increased support services to people in their homes, increased home help hours and increased care from public health nurses who do a fantastic job. The level of investment in community care is important. One of the significant issues we have not addressed as a society is the question of dementia care and dementia-friendly towns and cities. Will the Minister take on board the examples of many other cities and countries which are looking at caring for people in their communities while keeping people at home who would otherwise be in long-term care? We need to have a proactive approach in care for people with dementia in particular.

Concerns were raised about patients on hospital trolleys. We all encounter such cases every day. In Drogheda, I have not heard anything but the highest of praise for the nurses and doctors in the Our Lady of Lourdes Hospital. There is a significant appreciation of the professional care which people receive, notwithstanding the fact that it is on trolleys, which nobody wants.

If there is one significant inequality in the way the State's finances are organised and care is provided, it is in the area of prescription charges for those on medical cards. The sicker one is, the more medication one needs and the more one will pay on prescription charges. For those on medical cards, they must pay for prescription charges up to a maximum of €25 per month. It is wrong that medical cardholders on low incomes continue to pay prescription charges. As our economic situation improves and as we face into the general election, this should become an important issue to be addressed.

I welcome the Bill as well as the significant changes the Minister has made in difficult times in our health system. I hope this work continues.

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