Michael McCarthy (Labour)

I too welcome the Tánaiste and Minister for Health and Children and congratulate her on her appointment to that Department. She is a brave person to take on a troublesome area, a Department famously described by the Minister, Deputy Cowen, as "the Angola" of Departments. There is a great deal of work to be done in this area. In 2002 the coalition parties gave a clear commitment, at a time of unprecedented economic growth, to extend the medical card scheme to 200,000 people. Many people were lured to the polling stations and voted for the Government parties on that basis. In the two years since, we have not seen delivery of that commitment. Many commitments were made in various areas but none was more critical than this area which deals with a vulnerable section of society that is less well off than most. It is an undeniable fact that many people are forgoing the cost of visiting a doctor because they do not have the means to pay. That leads to the situation in which more and more people are presenting themselves at accident and emergency and are more distressed and in a worse medical condition than they would normally be.

When the Tánaiste took up this position she said that figures revealed the cost of extending the GMS to 100,000 people is approximately €150 million. Our spokesperson, Deputy McManus, has done a great deal of work in this area and following her research maintains that the same amount of money would cover approximately 200,000 medical cards. I call on the Tánaiste and the Government to end the litany of promises made in this area and to extend the income eligibility for people to qualify for medical cards.

One Minister described the extension of the scheme to 200,000 people as "extraordinarily expensive". I presume many of these policy areas were costed at the time of the election. If it was not "extraordinarily expensive" in 2002 how can it be so in 2004? To make the commitment in the first instance someone, somewhere must have costed that proposal. I do not accept the proposal from the Tánaiste or anybody else that it would be "extraordinarily expensive". It is a good investment and it would be money very well spent. No one in Government could deny that. Surely there is enough money in the budget surplus of €2.3 billion to cover the cost of extending the income eligibility to those to whom it was promised.

We must impress upon the Tánaiste that it is money well-spent and if we do not spend the required amount of money in this area there will be an unnecessarily high demand on the resources at accident and emergency as people will present themselves there if they decide not to attend GPs because of the prices some charge. To someone on a social welfare payment of €140 a week, €40 or €50 is a lot of money. Few Members of this House could live on those rates of payment. It is also an indisputable fact that there are 100,000 fewer people in receipt of medical cards now than there were in January 1997 when the rainbow Government was in power. There is something seriously wrong if more people received medical cards when the country was less well off. We have had the Celtic tiger and unprecedented economic growth yet fewer people are receiving medical cards. The medical card qualification is the lowest since the GMS was introduced 32 years ago. That alone should be a wake-up call to the Government.

The figures prove that the promise to extend the scheme was a sham. The Tánaiste said on her appointment as Minister for Health and Children that she does not have a political ideology but she does have political practicality. The practical experience of any Member of either House should be that there is a section of society which is less well off than most, which is vulnerable and is being directly affected by the Government's decision not to extend the GMS. That is shameful. I hope that while the Tánaiste occupies the Department of Health and Children there will be a change in this policy, that we will see real action in this area and an end to the litany of false promises, and that the Government will stop taking advantage of the most vulnerable people in society.