Joe O'Toole (Independent)

He is a man I might acknowledge is related to me and, I might acknowledge to the Fine Gael people, although he might be slow to admit it, a man whose people came from a house in south Connemara that is a very strong Fine Gael house before he moved up to the next county. I welcome him and it is great to see him looking so well.

With the permission of the House I wish to share my time with Senator Norris. I welcome the Minister to the House and I echo the words said previously about her record of availability to Members of this House to deal with issues. It is well known in this House that I admire much of what she is doing in health and I have regularly been prepared to defend issues and points made in this House by the Minister. Both my colleague, Senator Norris, and I have taken great issue with personal attacks on the Minister.

I was delighted to see the Government make the change. I do not have any problems with change of mind or U-turns because Governments are there to deal with issues and to find solutions. However, I disagree with the partial impact of the change. All the anecdotal evidence has been to the effect that the health of the over 70s has improved significantly since the introduction of universal entitlement to the medical card for that group of people. If for no other, this is a good reason to have introduced it and to maintain it. I ask the Minister to consider it on that basis.

The movement from gross to net income was unfortunate. I took serious issue with the line on the Department of Finance website on the morning the decision was made which stated it was being moved to gross income more or less because people understand their gross income more easily than their net income. This line, which is still on the website, is facile, flippant and irritating. I will explain why.

To give a real life example, I recently spoke to a man earning €40,000 a year who would be outside the qualification level. He is in his late 60s and, unfortunately, his wife has advanced Alzheimer's and eventually had to be brought to a nursing home. The cost of that nursing home is just under €4,000 a month — I cannot remember the exact figure but it is close to €47,000 or €48,000 a year. In his situation, the nursing home cost is more than his total income. To give the full story, he has two children who, despite being in comfortable but not superb jobs, are sharing the cost with him, as many people would do. It is a responsibility we all face at some stage.

It seems grossly unfair that this man would not qualify for a medical card. In his case, an issue of net income comes into play. I know there is a system of appeal but that does not appear to be set to deal with this particular issue. The net issue is the only issue that counts. The man also told me of previous physiotherapy costs and a number of other costs before his wife went into the nursing home. While I do not purport to know all the details, this is an example of why we should be reconsidering this area.

I have known the Minister long enough to know she would not deliberately misinform me or anybody else. However, I do not accept only 20,000 people are outside the limit. I have tried to put together figures in this regard and I have been able to judge the number of teachers who would not qualify. Between primary, post-primary and third level, I estimate that approximately 15,000 or about half of retired teachers would not qualify, although I stand to be corrected on this if the Minister can correct me. If I add to that the number of retired gardaí, nurses, civil servants and public servants who would be outside the limits, before even considering those in the private sector such as retired bank officials with occupational pensions, I cannot accept there are only 20,000 people. While I cannot disprove this at present, I intend to do so. I just do not believe it possibly could be correct that only 20,000 people over 70 are outside the limit. While I recognise that some of my figures apply to people in their 60s rather than their 70s, I do not believe the global figure.

Those are the nuts and bolts issues. The fundamental difference I have on this issue is that I disagree with the Minister's point on medical cards. I am not in favour of giving medical cards to millionaires. I am in favour of universal access which should be paid for through proper taxation and other means. Rather than setting up a system of trying to measure who gets under the bar and all that goes with this system, the most honest way in a republic and a democracy is that everybody over 70 would have universal access. While I do not see them doing it, if Michael O'Leary and the lads want to queue up and apply for a medical card, they will get the same as everybody else. They pay their taxes and that is their entitlement. To be fair to that man, he pays his taxes in this country.

I have effectively made four points: first, on the improvement in general health, second, on the net figure as opposed to the gross figure, third, on the numbers, which I disagree with, and fourth, that we live in a democracy where there should be universal access paid for by tax rather than by getting under the bar at the age of 70 or over.