Martin Browne (Tipperary, Sinn Fein) | Oireachtas source

I will focus on the medical card aspect of this Bill, given the provision to exclude income relevant to the rent a room tax relief for consideration for a medical card means test. I cannot help but take issue with the fact that, as a measure, it does not treat all people equally in that property owners who participate in the rent a room scheme can have that income disregarded when it comes to medical card assessment. What about workers and families who are living in overcrowded accommodation and who do not have a spare room? Many of them cannot get a medical card and this Bill does nothing at all for them. In addition, there are many people who, because of their income, might fall just over the income threshold and do not qualify. When measures such as this are taken, how does the Minister think those families feel? We are all well aware of constituents who cannot afford doctor's fees but who fall above an income threshold that has not been reviewed for 20 years and has no relevance to today's demands. The most the Government can do is to tell them if they rent out a spare room, it will increase the limit for them. This lopsided way of skirting around an issue that needs to be dealt with is a blatant disregard of so many people. The truth is that it is getting more and more difficult for low-income workers and families to get access to a medical card. This is where the Government should be focusing its efforts and not skirting around the edges. This is what the Government should be seeking to address in 2024, as Sinn Féin has proposed to do by raising the income threshold to increase the number of medical cards by 400,000 while also reducing the drug payment scheme threshold to €60.

The Government needs to take decisions that matter to people and not dabble around for the sake of making it appear it is making a difference to the manner in which people can manage their health. It should also be taking the opportunity to implement a minor ailments scheme in pharmacies, a pharmacy first model for guidance and advice for minor ailments. These areas are where the Government needs to focus its efforts.

Community care is a key factor in addressing the demands on GP and acute hospital services, but the pathway to primary care medicines and other services is the medical card itself and, in this area, the Government is relying on an outdated threshold. It is preventing people from accessing alternative services that could prevent hospital presentations, yet in this Bill the Government is confining the change to a small group of people while leaving others to continue going without. Sinn Féin has a plan that will treat people better, take the pressure off emergency services, and can open up a range of medical services which, as matters stand, are today obscured by the obstacle of affordability.

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