Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I move: "That the Bill be now read a Second Time."

It is my great pleasure to introduce the Bill. I was pleased last December when the Government announced that eligibility for a GP service without fees was to be extended to everyone who receives a carer's allowance payment. Following further examination of the proposal, the Minister for Health confirmed in April that this measure should also be extended to people who receive carer’s benefit. The purpose of this Bill is to provide a general medical and surgical service free of charge to people who receive half-rate or full-rate carer's allowance or carer's benefit. The Bill will result in approximately 14,000 additional people being eligible for a GP visit card, thereby enabling them to access vital GP services without having to consider their ability to pay for this service.

We all agree that carers are the backbone of the caring profession in Ireland. Their selfless dedication to providing hours of unpaid care to their loved ones and families is a major contribution to the provision of care in every community. Each caring role is different. Becoming a carer is a life-changing experience. It can be sudden for some carers, while for others it happens gradually over time as the care needs of their loved ones increase. For some carers, the time spent caring is a period of weeks while for others it lasts a number of years. Despite these differences, all carers begin the journey for the same reason. They are motivated by their love for the person they are looking after and the need to ensure they are provided with the necessary care and support they require.

The contribution of carers to our society is measured as part of the census. According to the 2016 census, more than 195,000 people, or 4.1% of the population, provide unpaid assistance to others. This represented an increase of more than 8,000 people since the 2011 census. A total of 6.6 million hours of care is provided each week, with some of this care being provided on a 24-7 basis by family members or unpaid carers. As the census figures have shown, there is an ever-increasing need for care. This need, which is being met by unpaid carers, can be expected to increase as our population continues to grow and the proportion of people living longer continues to increase. The CSO projects that the population aged 65 and over will increase by 59% by 2031. The number of people living to the age of 85 or more is forecast to increase by 97% over the same timeframe.

While the number of persons living longer is something to be celebrated, we must acknowledge that it is likely to place further demands on family members and friends to undertake caring roles. Studies emanating from the Irish longitudinal study on ageing have shown that more women will be caring for dependent children and elderly parents while also playing a more active role in the workforce and that this generation will become more relevant as our population continues to age. The impact on the health and well-being of carers is likely to increase as more and more unpaid care is provided by family members and loved ones. Therefore, the provision of a free GP service is another important step by the Government to provide much needed supports to carers.

I would like to reflect on the development of the first national carers strategy, which was published by the previous Government in 2012. It recognised the significant contribution and commitment that family carers make and the concerns they face. The strategy sets the direction for future policies, services and supports provided to carers by Departments and agencies. When I reviewed the strategy recently, I noted that its vision statement reads:

Carers will be recognised and respected as key care partners. They will be supported to maintain their own health and well-being and to care with confidence. They will be empowered to participate as fully as possible in economic and social life.

I am sure Deputies will agree that the measure we are debating supports carers in maintaining their health and well-being and caring with confidence.

General practitioners, GPs, provide support and assistance to carers in managing and maintaining their health and well-being. We are all too aware of the various health impacts suffered by carers, including the physical strain on their bodies and the associated mental health impacts. General practitioners also play a vital role in assisting the carer to care. General practitioners are valuable resources who have excellent knowledge of the supports and services available to carers in a locality. This is why we want to extend access to GP care for carers. While many carers might in theory have access to GP care, that care may not always be accessible due to the financial barriers carers may face.

Carers often have to reduce their hours of work or even give up work entirely but, although this is often done unselfishly, it does place a financial burden on their shoulders. Removal of this barrier and the introduction of free GP care to an additional 14,000 carers will therefore prove to be a significant benefit. Some 14,000 carers will benefit from this legislation. Carers' financial worries or anxieties regarding their ability to pay for this service will be eliminated. Instead, they will have access to high-quality GP care centred on their needs, which will ensure their own health does not deteriorate, particularly as we know that their health tends to do so gradually as their hours of caring increase over time. The HSE has indicated that carers will be able to apply for a GP visit card from 1 September 2018. Applicants will be facilitated to make either a paper application or an online application.

This measure is just one of a series of measures introduced in recent times to aid carers. As Members are aware, there were successive €5 increases in social welfare payments for carers in budgets 2017 and 2018 and an extension from six to 12 weeks for the continuation of these payments after the death of a cared-for person or that person's entry into residential care. This has gone some way towards easing the financial burden on the shoulders of carers. Last December, additional investment in respite care services, of €10 million, was announced. This will enhance the provision of respite care to people with disabilities, enabling more carers to take a break from the daily caring routine. It will provide them with much-needed time to maintain their own health and well-being. These actions reflect the commitment in A Programme for a Partnership Government to have a stronger voice for carers. We have listened to carers and have taken positive actions to address their needs.

I will now outline in general terms the main provisions of the Bill. Section 1 provides the relevant definitions to the Health Act 1970 and the Health (General Practitioner Service) Act 2014.

Section 2 provides for an amendment to section 47 of the Health Act 1970 in order that the HSE's appeals process can be extended to encompass this service.

Section 3 provides for an amendment to section 47A of the Health Act 1970 in order that the HSE's current "ordinarily resident" framework is extended to cover the provision of a general practitioner medical and surgical service for persons in receipt of carer's benefit or carer's allowance.

Section 4 provides for a new section 58D in the Health Act 1970 to provide in law for this new service. Section 4 of the Bill contains the text of the new section 58D, which has five subsections. Subsection 58D(1) provides that the HSE shall make available without charge a general practitioner medical and surgical service for persons in receipt of carer's benefit or full or half-rate carer's allowance. Subsection 58D(2) requires that persons in receipt of the carer's benefit or full or half-rate carer's allowance, furnish any necessary documentation the HSE requires from applicants to establish if they are, or continue to be, eligible for this new service. Subsection 58D(3) enables the HSE to deem persons in receipt of carer's benefit or full or half-rate carer's allowance who do not furnish the necessary information required as not eligible for the service provided under section 58D. Subsection 58D(4) provides that the HSE, insofar as it is practicable provide a choice of GP for the services provided under section 58D. Subsection 58D(5) provides that in "Act of 2005" means the Social Welfare Consolidation Act 2005.

Section 5 provides for the Long Title and Short Title of the Act and relevant commencement provisions.

All of us will be touched by caring at some point in our lives, whether we take on a caring role or need care ourselves. For me, this Bill is about looking out for people who spend their time looking out for others. Caring for those in need provides a major contribution towards health and social care in Ireland. Our Government recognises the major contribution carers make to the welfare of others. We aim to strive for a society that respects, values and supports carers. The needs of carers are being considered across Government and I hope we will receive cross-party support on this important legislation. I am personally very pleased to introduce this legislation. I would like to take this opportunity to stress the importance of enacting it before the summer recess in order that this service can be in place for carers in September.

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