Thomas Pringle (Donegal, Independent) | Oireachtas source

I welcome the Minister and the Minister of State to their roles and wish them all the best. The Minister has probably the most difficult job and Department in the Government. He knew that before he took the job, however. It is his own fault whatever happens.

In all seriousness, it is a job that could have huge potential and give huge rewards. It can definitely have huge rewards for the citizens which is most important. If it is tackled in the right way, it can be hugely significant. I hope that is what the Minister intends to do. Unfortunately, past Governments have shown they did not intend to do that, focusing instead on budgets and money. If that is the way the Minister sets out his stall on it now, unfortunately we will lose.

I welcome the Bill and its criteria will be welcomed by every Member. I do not believe anybody will oppose it. I do not believe it has gone far enough, however.

That is hardly surprising to the Minister, but it is the case. As Deputy Joan Collins mentioned, what the Covid crisis has shown is that we can achieve things so long as we stop talking about and strangling ourselves with budgets straight away. The budget for the health service is not enough. It must be increased. There is a great deal of rubbish talked about doing more for less and so on. That is a load of crap. The bottom line is that more funding needs to be invested. It will cost more for 15 or 20 years initially until we have dealt with the waiting lists and other problems, but it will then start to save money and grow cheaper as time goes on. That timeframe is outside of what any politician will spend here or as a Minister. Perhaps that is why nothing ever happens and there is no change. That is a problem, but recent months have shown that the issue can be dealt with and changed.

We cannot permit a recurrence of the problems of the past. For example, beds were closed in the 1980s and early 2000s. That pattern cannot continue. If it does, there will still be a crisis in ten years' time and those of us who are still in the Dáil then will be discussing the same issues. We must consider this issue.

Deputy Joan Collins touched on an issue that I believe can be sorted easily, that being, ensuring that cancer patients get medical cards as a right. The Health Act 1970 sets out that medical cards are awarded based on income, not medical need. My office in Killybegs is regularly attended by cancer patients who are over the income limit and consequently cannot get medical cards. Unfortunately, they must go through the process of income assessment and so on before their medical conditions are considered. That is the problem, and it dates back to the 1970 Act. No Government has been willing to address the Act. To do so would be to open up the criteria for making cards available. However, it must be addressed. Will the Minister ensure that it is? It would make a significant difference in many people's lives. I talk to cancer patients whose diagnoses have not been accepted as conferring an entitlement to a medical card. It is wrong that people still have to go through that. They have the stress of having cancer and, on top of that, the stress of not knowing whether they will be able to access medical services.

I will pay tribute to the Oireachtas Library and Research Service. The Bills Digest it has prepared for this legislation is useful and has put words to many of my thoughts on the health service. It references what the World Health Organization, WHO, says about our health services: Ireland uses income, age and health status to determine eligibility for publicly financed health services; this unusually complex approach has led to notable gaps in coverage and inequalities in access to essential health services; Ireland is the only country in western Europe that does not offer universal access to primary care; and it also has a large market for private health insurance, which mainly benefits richer people. This sets out in a nutshell the problem with our health services.

If we base access to services on people's incomes, it will cause problems. If we base it on private medical insurance, which is essentially for wealthier people, they will get access over and above what others get. How often do we as Deputies hear about someone who has been waiting for a CAT scan or something along those lines being told that there is a two-year HSE waiting list but that he or she could get it the next week if he or she paid for it? That is the reality. If a procedure can be paid for and done next week, then it can be done next week for a medical card patient as well.

These are the issues that the Minister must address. I hope he will do so. Unfortunately, history is not on his side. Perhaps we will see changes - I hope we do. If we do, I will support them. However, I will wait to see whether it happens.

See this speech in context