Brendan Ryan (Labour)

I welcome many aspects of the debate. It appears that everybody agrees there is something wrong with our primary health care system. I do not think I heard a single instance of dissent from that view. The trouble is that we knew, because it is well documented, that a good primary health care system is the essential prerequisite for a good hospital care system and a good health care system for elderly people and children. Everyone knew that seven years ago and yet we have been in the extraordinary position that the Government decided to spend a vast sum on the health services. After having done so, it produced a health strategy. It had been in office for almost five years before it did so. What it was really saying was that it had spent a great deal without knowing what it was doing; it worked out the strategy afterwards.

It would not have taken much serious reflection to see that two things would happen, the first being that eligibility for medical cards would drop proportionately as prosperity increased. This country was prosperous before the coalition came to power. It inherited a prosperous country and its job should have been to manage it. Instead, it has spent more time pretending that it created something that it inherited and that others are the cause of the problems it did not solve. In both cases, its energy could have been better devoted to confronting the fundamental fact that primary health care is the bedrock of a good health care system.

It was inevitable in a period of spectacular and welcome increases in prosperity that eligibility issues would arise. It is the most extraordinarily belated conversion to hear everyone on that side of the House tell us that there is a problem with eligibility and affordability. It is not often that I defend them, but we have at least begun to move away from blaming the GPs for this problem. In a piece that I wrote recently, I pointed out that if I go to see my GP, it costs me €45. I wanted to get my electric cooker fixed and the company said that it would cost me €100 to get the person inside the house.