Maurice Hayes (Independent)

I too welcome the Minister to the House and add my congratulations to her on taking over this portfolio. I have great confidence that she will bring the same energy and success to that as she has brought to other jobs in Government. I was cheered by her response to, and concern for, the very real problem of people caught in the poverty trap on the threshold of the medical card eligibility.

Senator Henry quoted from the ESRI report on health status. I take that with a grain of salt because health status is influenced by more elements than health care. The dominant factors are genetics, environment and lifestyle. Health care accounts for approximately 20% of that. These are matters over which the Minister and the Government have only indirect influence and it is unfair to pillory the Minister for this. One figure however, did bring me up short, namely, that at a certain point of moving out of eligibility, utilisation of the GP service has dropped by half. This suggests that those who most need the service and are most dependent on it are forced to give it up or forced to make enormously difficult choices about depriving their children of health care or finding some other means to balance the family budget. This aspect needs to be addressed.

Part of the problem is that the rate of health care inflation is higher than the rate of inflation in the general economy. To increase health budgets in line with general inflation is normally not enough. People are caught in the trap whereby because they are earning a few more euro per week they are suddenly faced with enormous health bills. We need to find a way to cushion that.

Apart from that I agree with a great deal of what Senator McDowell said. The concentration needs to be on how we run primary care. People often jump up and down about bricks and mortar in hospitals. However, a well-developed primary health care system would help us to deal with many of the problems now presenting in hospitals. I would prefer to have a free system and recover the money through taxation or some other means.