Brendan Howlin (Wexford, Labour) | Oireachtas source

I also welcome the Ceann Comhairle's statement on the voting controversy in the House last Thursday. I, too, regard it as a most serious matter that deserves to be addressed urgently and resolved.

The Government recently announced plans to extend free GP care to children aged seven and eight years. As the Taoiseach will know, the previous Government provided GP care for all children up to the age of six years and for those over the age of 70. The move to provide it for the under-eights is a slow realisation of the pledge made by the previous Government to provide free GP care for all. It suggests the current Fine Gael-led Government is not convinced by the arguments made in the Sláintecare report for a single tier public healthcare system, rather than the current two tier one. It is also another example of the poor use of public finances. The Government will have to negotiate with the GPs again to agree a new contract to cover the under-eights. What then? If it free GP care is expanded further to the under-tens or the under-12s, it will require new contracts. How many contracts will it take before the Government reaches the objective of providing free GP care for all? How much more time and money will it take to go through the various rounds of negotiations? Every time there is a new contract, the public finances lose leverage over the whole project and the next phase becomes more expensive. It would be much better value for the money to move directly to providing free GP care for all those above the age of 18 years, which is what we had envisaged, rather than take a series of incremental steps. We know from medical statistics that older people and the under-sixes use GP care services more than most and they already have access to free GP care. By and large, people with major medical needs have a medical card.

There is simply less medical need among the population of older children, teenagers and working adults. It does not require an incremental approach. It should be done as one negotiation. It is inefficient to drag this process out and it represents a failure of Government to deliver. We were able to negotiate care for children under the age of six in the worst of times but no progress has been made on this critical issue over the past three years. I have two questions. Will the Government agree to extend free GP care to everyone or at least to those under 18, rather than the policy announced by the Taoiseach of simply adding another two years to include those under eight? If not, will the Government at least produce a cost-benefit analysis of both courses of action?

See this speech in context