Micheál Martin (Cork South Central, Fianna Fail)

Employment growth has an impact. If thousands more are at work, they go over the eligibility threshold and, therefore, lose their medical card.

My Department has requested the health boards to engage in an ongoing review of the GMS list. That exercise is nearing completion, with dedicated teams in the health boards working with the GMS payments board to quantify any discrepancies on the GMS lists. Health boards are also identifying the level of overpayments to doctors which may have occurred. When the full extent of the overpayment is known, arrangements will be made for the recovery of these moneys from the doctors concerned. It is intended that a national approach will be adopted and that there will be discussions with the IMO with a view to agreeing a methodology for the recovery of them.

Equity in health care is one of the principles on which the national health strategy is based and one to which the Government is committed in the implementation of the strategy and through service development across the board. The overriding necessity in relation to equity, as was well recognised in the work of the health group within the national anti-poverty strategy review, is the need for access to services. If equity is to be met in a meaningful way, services must be built up, waiting lists reduced and activity increased. Specific groups, such as children and those with disabilities, require targeted service developments to address previous neglect and unmet need. Equity is a broad brush across the board.

A broad strategic focus is essential to address these issues. No single narrow approach will address the real need for better and more equitable health care services for all. The issue of prioritisation arises in this context. Choices must be made.

The first national goal of the strategy, Better Health for Everyone, deals explicitly with the issue of health inequalities in Ireland. It sets out a range of actions specifically directed at disadvantaged groups and concerned with ensuring they do not continue to suffer most ill health. Following an extensive consultation process with disadvantaged groups, carried out under the auspices of the working group on the NAPS and health, NAPS, national anti-poverty strategy, health targets have been included in Building an Inclusive Society.