Déirdre de Búrca (Green Party)

A Government should be capable of making decisions that may not be very popular among the public. This Health Bill advocates as fair a system as could be asked for by the State in the sense that, under it, 95% of older people will be looked after.

The system we are introducing in the Bill was designed to minimise hardship and undue anxiety among those over 70. Those aged 70 and over on 31 December 2008 who have non-means-tested medical cards will not be subject to the new means test. For those who turn 70 in the new year, there will be a much more simplified means test compared with that which they would have been subjected to had they been applying to participate in the standard medical card scheme.

The Government was very aware that, even with the simplified procedure, people would find the application process difficult. Consequently — the Opposition should recognise this — the Minister accepted an amendment on Committee Stage requiring the HSE to provide supports to any person making an application for a medical card if he or she requires such supports by reason of incapacity. That is a very fair concession. We recognise that, under the new system, there will be an eligibility test involving an application process. It is important that the Government is putting in place the supports that will ensure no older person is overwhelmed or finds himself or herself disadvantaged by reason of incapacity or inability to go through the application process.

The Government was very keen to ensure persons aged 70 and over would not lose their medical cards as an immediate consequence of the death of a spouse. I have been contacted by a number of constituents, including older people, about this issue. They are very concerned that the death of a spouse might mean the sudden loss of their medical cards. For this reason, the Minister tabled an amendment on Committee Stage in the Dáil to ensure that persons aged 70 and over would not lose their medical cards as an immediate consequence of the death of a spouse. A person aged 70 or over whose spouse dies on or after 1 January 2009 will retain the medical card for a period of three years at the same limit, of €1,400, as for a couple provided he or she remains within that limit.

It is very clear from this Bill that every attempt has been made, by way of legislative change, to ensure no older person will end up disadvantaged by the new system or will find himself or herself incapable of filling out the necessary application form associated therewith.

At a time like this, we must be honest with the people about the circumstances in which we find ourselves. Increasingly over the coming months, we will be calling on the Opposition to be such. When in opposition, it is very easy to call for universal entitlement to all kinds of health care services. Unfortunately, for the foreseeable future, health resources will be significantly constrained. We must be realistic with people about what the State can afford. We need a sustainable health care system that is affordable. The Health Bill provides for a system that will look after the health care needs of older people and provide coverage for those who need assistance in paying for their medical needs. The 5% who are excluded by this Bill will not regard it as unfair that the Government is not providing for a system that will cover their medical needs. We have examined this issue closely and have put the fairest possible system in place. It is for that reason that the Green Party feels it can support the Bill.