Fiona O'Malley (Progressive Democrats)

I welcome the Minister to the House. I was looking through my notebook this morning and came across a quote I had written when I was involved in a debate with an economist. The comment he made was that politics always wins out over economics. I thought that was a depressing remark for somebody to make because when one is in politics, one must have the bigger picture and the long-term issues in one's sights at all times. In dealing with the principle of universality in respect of medical cards for the over 70s, this was the one time economics won out over politics.

The Minister made the points very eloquently in her contribution. With the declining resources in the economy, is it fair that those people who can afford to pay for their own medical care should pay when there are many people who are more deserving of the State's declining resources? If they are denied access to State services, where is the fairness in that? The Minister had the courage to take on that principle of universality and stake her claim that she stands up for a fairer system which will deliver the resources of the State to those people who are in greatest need.

I have sat through the debate as it has continued and there is one aspect that has been ignored, especially by Fine Gael speakers, and that is the economic position. The Acting Chairman addressed that issue in his own contribution, as did other speakers. We cannot continue to insist that services remain in place when it is clear the resources are not available to pay for them. I came across a great oxymoron in the title of an article, If It's Free, How Much Does It Cost? In this instance, the cost of something that is free comes to the Minister's desk. She is very much aware of the cost of something when it is free to people. If they have an entitlement, most people are not terribly concerned about how much it costs, yet it does cost and that is why choices have to be made with a limited budget.

I applaud the Minister's decision, particularly as the escalating costs of medical cards for the over 70s is often ignored. People only ever speak about the €100 million it cost this year, the €250 million it will cost next year, the 14% increase and so on. That is something that must be curtailed and it would be reckless in the extreme if the Minister had done nothing to try to curtail those costs.

I allude to what Senator Feeney spoke about. I accept Senator Fitzgerald's point that the Minister at the time must accept some responsibility in negotiating a price but I do not believe that the then Minister or Minister for Finance ever thought that, on the introduction of a universal card, the State would be required to pay four times the going rate. I am sure it never occurred to them at the time. Fine Gael's very able and capable James Reilly, now Deputy Reilly, seized the opportunity on behalf of the medical profession, and they were well rewarded for it. I am aware this issue has caused an element of disquiet within the Irish Medical Organisation. Many members of the IMO are happy that a more realistic and sustainable payment will be agreed. I welcome that and hope the IMO will agree to the terms because it is a much fairer system. At least the reformed system for the new medical card scheme will be more affordable.

It is important that the moneys available to the health budget go to the patients in the first instance and for services. Containing the costs to the doctors somewhat is something that is to be welcomed.

The Minister made mention of the statistics, and it was referred to by other speakers, and said she was certain about the figures for the 20,000 people who will now qualify. I want to ask a question about the statistics available to us. On previous occasions when we introduced various benefits the statistics have not always been good. Is the Minister confident that the statistics available to us across the board are correct? This is an area in respect of which we cannot afford to obtain incorrect information. I would welcome the introduction of identity cards for all citizens if this would assist in ensuring the statistics are correct.

I welcome the decision the Minister has made and also the changes that have taken place. She has taken vital action and stood up for a principle, which is important. I compliment her on the courage she has shown.