Mary Henry (Independent)

Virtually everything that needed to be said has already been said. There is just one matter that I would like to raise that has not yet been mentioned. One of the serious difficulties with such issues that the Department of Health and Children, the hospital services board, and primary continuing community care have when planning health services is the lack of knowledge on patient numbers, something brought into sharp focus by the extension of medical cards to over-70s. At the time, I said that I welcomed it, although I thought that others deserved a card more than all those over 70 without a means test. However, the measure has now been introduced. I recall that at the time it was believed that approximately 35,000 people would avail of those medical cards. I understand 67,000 people have now registered for such cards. How can the Department plan when it has such inaccurate figures? This not only relates to financial planning but the planning for places and knowing where they are needed. It is impossible to do so at present.

The same situation may arise in respect of the extension of the medical cards on a doctor-only basis. I welcome that measure. It would have been nice if it had included doctors and medications covered by the cards, but we have no idea how many extra people will be covered or whether the primary care system can cope with this number of people.

I suggested on numerous occasions in this House that one solution that would help would be if people were assigned personal identifier numbers at birth. That would enable us to identify the number of people coming into the health services each day, month and year and the number who need immunisation at six weeks, six months at two years and so forth. Such an identifier number would enable us to plan. It could be described as any great intrusion into people's privacy. There has been a move towards that with the establishment and greater use of PRSAs.

I would be grateful if the Minister of State conveyed to the Minister for Health and Children the relatively simple solution of giving people an identifier number. Then we would have some method of planning ahead and would know what number of people might require each service or what unforeseen cohorts might require services. It would also help us in terms of financial planning.

I can understand why this legislation is being rushed through in this way. I regret that, but huge amounts of money will have to be expended by the Department which it did not expect to expend. It will have to produce the money from somewhere. Those unfortunates who are not legally liable to pay these people, under the legislation, will have to pay up. I regret that the people concerned cannot be refunded all the money they paid out, given that if one owes income tax, one is required to pay every last cent. I am sure the vast majority of these people were hardworking taxpayers all their lives and I very much regret that they will not be recompensed in full for money that should not have been taken from them in the first place.

I urge the Department as a matter of urgency to put in train some form of planning; an identifier number being the best mechanism of which I can think. We have had example after example where the Department did not have a notion what initiatives were going to cost. This is an issue of money being expended, of which the Department did not inform us. A great amount of tax relief was given for the building of private hospitals, but we find that the Department of Finance has no idea how much this initiative will cost. Day after day we find out there was no notion what an initiative was going to cost. That cannot be the way to run a proper health service.