Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I welcome this motion to establish a special aII-party committee to develop a single, long-term vision plan for healthcare. This is a positive step, albeit one that should have been taken a long time ago. For too long, our health system has been in crisis. This crisis can be boiled down to two key failings on the part of successive governments: first, a fundamental inequality in how patients are treated and differentiated on their ability to pay and their location and second, the incapacity of the system to deal with even demographic pressures, as evidenced particularly in emergency departments and maternity care.

Universal health care, and not universal health insurance, is the solution. I welcome therefore the reference in this motion to "the need to establish a universal single tier service where patients are treated on the basis of health need rather than on ability to pay". Sinn Féin has long been committed to the realisation of a world-class system of universal health care accessed on the basis of need, free at the point of delivery and funded by progressive taxation.

As my party's health spokesperson over the past 14 years, I have consistently argued for such a system of health care delivery. I am encouraged by the growing number of voices adopting this position and by the albeit slow but hopefully real movement by Government away from the health insurance model, whether multi-payer or single payer. Welcome on board. Fáilte ar bord.

I hope that the new plan will have a particular focus on disability services and their prioritisation. It was very worrying to hear yesterday that there are proposals, once again, to raise the age of those entitled to disability allowance from 16 to 18 years. This, we will all recall, is the same proposal on which the former Minister for Social Protection, Deputy Joan Burton, was forced to make a U-turn in 2013. Once more, we see the most vulnerable in our society being used as easy targets. This must not be allowed to happen again.

Changes should be made immediately to ensure that a full medical card is granted to every child qualifying for the domiciliary care allowance. My party colleague, Deputy Louise O'Reilly, will be seeking the support of Members for the adoption of this proposal. Despite the findings of the Keane report, the horror stories continue of seriously ill children being refused medical cards and the lengths to which distressed parents are being forced to go to secure a medical card. The Government must urgently introduce and implement a schedule for the extension of full medical cards to people with serious illnesses and disabilities without a means test, working towards a universal entitlement year on year.

I note and welcome the reference to the focus that needs to be taken on the changing demographics and on how best to re-orientate the health service on a phased basis towards integrated, primary and community care. A greater emphasis on community-based care has the potential to reduce the number of older people requiring nursing home care. However, this has not been quantified because, as the Department of Health report on the nursing homes support scheme makes clear, the further development of community-based care is dependent on new approaches. I hope that is exactly what we are about here today.

Sinn Féin estimates that as many as 13% of nursing home residents, possibly as high as the 30% figure given by ALONE, would be able to stay at home if the appropriate services were put in place. We are committed to the provision of health care services and social care services as a right, with equal access for all based on need and to the greatest extent that resources allow. This right is especially relevant for older people and the provision of supports for older people is becoming increasingly important as our population ages.

We should see improved health and longevity as an opportunity as well as a challenge, with older people contributing more and more to our society. In the words of the democratic programme of the First Dáil Éireann, we are committed to the care and support of Ireland's older people "who shall not be regarded as a burden, but rather entitled to the Nation's gratitude and consideration".

I wish to thank and congratulate all Members of these Houses, both the Dáil and Seanad, who have openly demonstrated their support for the Green Ribbon campaign throughout the month of May. The wearing of the ribbon is no longer required since it is 1 June, but our collective efforts to address and support the mental health needs of our population is a daily and yearly need. I hope that the establishment of this committee will not simply provide a talking shop but rather a gathering of people with ideas, vision, and most importantly, solutions, to bring about the changes that are so desperately required in our health system today.

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