Ulick Burke (Fine Gael)

I thank Senator Browne for sharing his time. I support the Labour Party motion. The Minister for Health and Children's speech was provocative and will anger most people who will read and analyse it. The jargon he used shows how out of touch he is. His recent actions indicate that his hands are tied, perhaps because he is being constrained by the Minister for Finance. We have been told on many occasions that substantial additional funds have been provided in the health sector. If the problem is not mismanagement, it must be that the Minister is unable to run an efficient health service.

The essential aspects of the Labour Party motion are quite clear. The fact that equity does not exist within the health system, although the Minister for Health and Children has said that it does, is exemplified by the problems with the medical card scheme. The Minister referred to the national health strategy, Quality and Fairness, a Health Strategy for You, but I wonder what people who are in need of health care think of such a commitment. He said that the health strategy sets out "the Government's commitment to health as a key priority," but if that is the case, why are waiting lists increasing in all sectors? In light of the decrease in the number of people who are eligible for a medical card, I ask the Minister to indicate clearly and immediately the largest categories of expenditure in the health system.

An increasing number of people suffer from asthma, coeliac disease and cancer. If people with such illnesses are guaranteed automatic access to medical cards, we will go a long way to allaying the crisis that exists. The discretion of chief executive officers in cases where medical evidence indicates a need for a medical card is, in effect, restricted as they have to operate within certain guidelines. They do not have the liberty to use their discretion fully. The Minister passed the buck, in relation to the provision of medical cards, to the chief executive officers of the health boards. Those officials do not have the discretion to set the guidelines. It is important that a total review of the medical card system takes place, specifically dealing with the categories I have mentioned.

Given that 2003 is the European Year of People with Disabilities, I ask the Minister for Health and Children to declare immediately, as a gesture of goodwill, that every person with a disability will be entitled to avail of a medical card, regardless of the income of their parents or spouse. Everyone is waiting for the Minister to publish the medical manpower report, a draft form of which has already been leaked. We have been led to believe that the Minister has received the document and is revising it.