Peter Fitzpatrick (Louth, Independent) | Oireachtas source

I welcome the opportunity to take part in today's debate. Access to healthcare should not be based on ability to pay but on medical needs and requirements. Undoubtedly there is a two-tier health system in Ireland. I welcome the Government's commitment to Sláintecare and look forward to seeing it implemented during this Dáil.

The Bill's proposals include the framework for the further phased expansion of GP care without charges for all children ages 12 years and under on a three-phased basis, and an increase to gross income limits for medical card applicants for those over 70 years. Phase 1 will bring children aged eight years and under into a free care system.

Phase 2 will bring those aged ten and under into the system and phase 3 will bring those aged 12 and under into the system. While I fully support this move, I do not understand why it is to be done on a phased basis. This is not fair on parents or on their children who urgently need medical help. In my opinion this should be introduced straight away across the board. Why do we need to phase it? This is only adding fear and worry to those parents and children who are affected. We all know that, during the Covid-19 lockdown, many people stayed away from hospitals and doctors surgeries because of the fear of the virus. Now we have another reason for those parents and children not to attend their GP. It is estimated that more than 300,000 children will ultimately benefit from this change. We must give them the benefit now and not introduce this on a phased basis.

In my constituency office in Dundalk we see situations almost daily where parents cannot avail of medical treatment simply because they cannot afford the cost of a doctor’s visit or medicine. In 2020 we cannot let a situation continue where parents of children are unable to access medical treatment. I welcome the changes that the Government are proposing today but I do not agree with the timing or phasing of these changes. We need to implement these changes straight away and not leave parents of sick children unable to access medical care because of financial reasons or fears. Families are struggling and need help. Prevention is the best cure. The Minister has the opportunity here to do something right. I ask him, please, to put all of the children into one phase.

I support the measure to increase the threshold for medical cards, which it is stated will benefit 56,000 people. All people over 70 years of age should be automatically entitled to a medical card. The Bill before us today proposes that those aged 70 years and single will be entitled to a medical card should their income not exceed €550. This limit is currently €500. Couples aged 70 years or over whose weekly income is below €1,050 will be entitled to a medical card. This limit is currently €900 per week. As already stated, all those 70 years or over should be automatically entitled to a medical card. These people have worked a lifetime, in many cases for 50 years, and have contributed to this country in many different ways, both financially and in other ways. I remember hearing once that a country should be judged on how it treats its elderly. If we are to start putting barriers in place for access to healthcare for the elderly members of our society, then we will have much to answer for. People at this age have enough challenges in life without worrying about access to medical care. In many cases they are among some of the most vulnerable in society who, after having given a lifetime of work and commitment to the State, deserve better. If the recent events in nursing homes during the Covid-19 crisis have taught us anything, it is that we must protect those who need our help, most especially our elderly.

On the issue of medical cards, there are many situations where a card is cancelled and the person has to make a new application. Many people, particularly those aged 70 years or over, sometimes forget to renew a card, and when the card is cancelled, this causes great stress and anxiety. We need to look at ways of making the renewal of medical cards, especially for those aged 70 and over, more user-friendly and less stressful.

A further point on medical cards for the over-70s is income limits. For example, a single person over 70 years of age has an income threshold of €550 per week while a couple aged 70 years or over has a threshold of €1,050 per week. This is not fair as a single person, who is more than likely a widow or widower, faces the same utility, gas, electric, coal and house insurance bills as couples, yet he or she has an income threshold half that for couples over 70. This person does not have to pay half the bills. This is simply wrong and unfair to the single person, who as I have already stated, is likely to be either a widow or widower. Having a situation of medical cards for all those aged 70 or over would eliminate this unfairness.

It is wrong in this day and age for those over 70 to be assessed for medical cards. They should be automatically entitled to one. They have worked long and hard to be entitled at the very least to medical and healthcare in their retirement. I strongly urge the Government to reconsider its position on this and encourage it to look to introducing universal healthcare to all children and to those aged 70 years and over at the very least. While I welcome the changes being made today, they do not go far enough. Healthcare in this country must not depend on one’s financial well-being. Every citizen must be entitled to healthcare regardless of their income. We must not discriminate against any section of society and must protect it when it comes to healthcare. In spite of everything that has happened over the past four months with Covid-19, we now have a great opportunity to invest in our healthcare system and to make it available universally to all citizens. I have a habit of saying that a person's health is a person's wealth, which I strongly believe in.

The Minister now has an opportunity to look after families, children and the elderly people who have made Ireland a great country. I wish him the best in his new position, and if he works half as hard as he did when he was spokesperson for Fianna Fáil, he will do a good job.

I come from Dundalk. We have a fantastic hospital there which is a minor injuries unit, MIU. Back in 2010 it was downgraded, which should never have happened. A great number of people travel daily from the Cooley Peninsula, Omeath and Lordship and pass the Louth County Hospital but cannot use its facilities. They have to go to Our Lady of Lourdes Hospital in Drogheda, which is another fantastic hospital but which is completely overstretched. I invite the Minister to come to Dundalk to visit our Louth County Hospital and the MIU and see the front-line staff we have there. Our health system needs to be upgraded and looked after and I promise the Minister that when he comes, he will see the services we have and will see the potential we have for going further. I wish Minister the best of luck and look forward to working with him as closely as I can.

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