Kathleen O'Meara (Labour)

It is with great pleasure that I second the motion. I understand that the new Minister for Health and Children, Deputy Harney, will attend the House later to speak on the motion and I welcome that. When she took over the Department, one of her first remarks was to note how the income threshold for the medical card had fallen and that it should be addressed. While I welcome that, the question has occurred to me as to where she has been for the past seven years. She has been sitting in the Cabinet which made the decision not to increase the income thresholds for the medical card. She has been sitting in the Cabinet responsible for the fact that fewer people now have medical cards and that people are in some cases facing serious hardship because they are over the income limit for a medical card.

Although there are many public representatives in both Houses aware of the hardship caused by the stinginess of the Government regarding this issue, and its failure in this as in other matters to live up to its promises, I will confine my remarks to Members in this House. We sit in our offices and clinics, meeting people who are struggling and cannot afford to go to the doctor. Senator Ryan has pointed that out graphically.

Children in poor families are one of the groups suffering. This morning I attended a budget briefing in the Mansion House by the End Poverty Coalition. That is an umbrella group for a large number of voluntary organisations working with children, including Barnardos, the largest charity, the Society of St. Vincent de Paul, the Children's Rights Alliance, etc. They have already made their budget submission and they consider it an absolute priority that the medical card income limits be extended. They feel the medical card should be widely available to children and they state that we can afford to make them available.

Poor families suffer from ill-health and that has been so in this country for a considerable period. In the past ten years in particular, and specifically in more recent years, we have had the resources to ensure that we can tackle disadvantage and poverty and deal with the fact that poor people suffer ill-health. This Government has chosen not to do so.

I have previously listened carefully to the comments of the Tánaiste, now also the Minister for Health and Children, and will listen carefully to her this evening because there seems to be a realisation that there is a problem. Whether that realisation is linked to results in the local elections of last June remains to be seen, but the budget will be a benchmark of the commitment of the Government to tackle the very serious issues facing us, particularly those related to poverty.

Another group comprises old age pensioners who are not yet 70 and have thus not reached the age of automatic entitlement to a medical card. They are aged between 66 and 70 and their pensions put them over the threshold for the medical card. I have met a number of these people, who live in fear of being ill because of what it can cost to visit a doctor.

Another group is single people on low incomes. They might be in their 20s and perhaps not supporting a family and children. They are over the income limit for a medical card but because they are on low incomes, they cannot afford to go to GPs.

I apologise for neglecting to welcome the Minister of State, Deputy Seán Power, to the House. I congratulate him on his appointment and we are pleased to have him attend the House. I put it to him, however, that we are paying an economic cost for the fear of single people on low incomes to visit a GP because of a simple lack of funds. These people must instead resort to an accident and emergency unit and we are approaching the winter when such units will come under even more pressure. It was noted in previous years that people used hospital outpatient departments because they could not afford to go to a GP. They are part of the significant number of people queuing in hospital outpatient departments, sometimes for days, for treatment which could possibility be administered at primary care level.

The second economic cost relates to those who do not attend a GP because of their lack of income and who leave an illness until such time as it may require hospital care, leading to absence from work and decreased productivity. We are short-sighted in our approach to this issue, given that the Government is so clearly committed to economic productivity, which is not bad in itself but should not come at the cost of people's health.

I look forward to hearing what the Minister has to say. There is no doubt policy on medical cards is not only leading to hardship but contributes to an increasingly two-tiered society in which, if one is on a low-income, one is effectively consigned to a life of hardship and one's ability to get out of the poverty trap is impaired.

On Monday last The Guardian commented on the British Government's stated policy of getting people back to work, which is a good policy. However, the newspaper noted that simply being back at work does not deal with the issue of poverty because of the problem of low income. Those in low income jobs need supports similar to supports received by those in other employment. We must also consider the position of low income families at work, in particular the implications for children. While there is a serious housing problem, I will confine my remarks to the subject of debate, which is related to health.

The medical card is an important instrument in assisting those in poverty and is particularly important for the children of poor families. In that regard, it is a serious public policy issue. I hope the Government is rethinking its policy and that the days of stinginess are over. In particular, I hope the days of assuming that somebody on a medical card visits a GP for the sake of it are also over. The figures show that people visit doctors when they are ill. Unfortunately, due to Government policy, many people are ill who cannot afford to see their doctors.