Jack Chambers (Dublin West, Fianna Fail) | Oireachtas source

I thank my colleagues, Deputies Billy Kelleher and Eugene Murphy, for sharing their time with me. I will start on a positive note. This is a very good measure, and it is good that all parties across the House are supporting it. We all campaigned in the general election on a platform of supporting people with disabilities, but particularly giving people in receipt of domiciliary care allowance the full range of primary care services and interventions they require. This Bill will deliver that for them. I welcome the fact that they will no longer have a cost impediment to addressing their complex needs in the context of the primary care system. The Minister stated in his speech that there will not be a charging mechanism in our hospital system for these people. However, the core issue we have seen in recent weeks is that their complex needs are linked with the relevant interventions, and it is a matter of providing this in the context of our acute hospital system.

As we know, the waiting times are beyond an obscenity. Delivering on a primary care basis and handing these people cards is one thing, but our core priority should be to deliver on all the other levels within our hospital system. The Minister has mentioned repeatedly in the press and elsewhere that he has the biggest health care budget ever seen in this country. However, we need only consider the outcomes for people in terms of their wait times, the acute hospital system and how people with certain diagnostic issues are being left with long-term disabilities because our health system cannot deliver for them. How much more allocation of money for the health system does Deputy Simon Harris need as Minister to deliver for those people for whom he seeks to deliver medical cards today? As Deputy Billy Kelleher said, this should have been the first thing the Fine Gael-Labour Party Government delivered for people. Handing a free GP card to everyone under the age of six was a popular, broad-ranging measure but it did not consider need or means. When we are apportioning resources in the context of a very difficult health budget, we should prioritise those who have complex needs and those who cannot afford health care.

That is something the Government failed to do in its negotiations with the National Association of General Practitioners, NAGP, and the Irish Medical Organisation, IMO, to deliver that previous measure.

I also welcome the change to the prescription charges. In 2011 the Government stated it would abolish prescription charges but they multiplied significantly. It is ethically wrong that the State is profiteering on prescriptions which improve patients' long-term outcomes or keep them alive. A lady in my constituency spent four weeks in Connolly Hospital because she could not afford the prescription charges. She receives a non-contributory pension and could not manage her bills or buy her prescription and developed cardiac failure. She recovered and was discharged but people like her present at emergency departments.

We need a vision and pathway for the health service. The Minister has repeatedly referred to the outsourcing of that to the Committee on the Future of Healthcare, which is playing an important role. The Minister, however, needs to define what system he wants to create and how he sees it in the short to medium term. We have the biggest health budget ever but the worst delivery. This Bill contains a welcome measure for those in need. It does not, however, give any indication of health policy or whether people who cannot pay can be guaranteed the orthopaedic or cardiac intervention or whatever they require without having to wait a significant length of time.

Deputy Billy Kelleher said during Priority Questions that under the health care legislation people who pay for private health insurance, and have paid their taxes, must in effect pay twice in the public hospital system. That is a form of double taxation. It is wrong. The State is incentivising hospital management to profit from people who pay their insurance. That needs to change. However, I welcome the overall thrust of what the Minister is doing tonight.

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