Cecilia Keaveney (Fianna Fail)

I am interested in the claims made by Senator Bacik and others that the most vulnerable and needy are being hardest hit. When the changes to income limits and the proposals on doctor only medical cards were made in the budget, massive headlines were published announcing that the most vulnerable were under attack. Anyone who claims that an income limit of €700 for a single person or €1,400 for a married couple attacks those on low and middle incomes is not being honest. We have to be honest in this debate.

I welcomed the introduction of the medical card for everyone over the age of 70. It cost a lot of money because Deputy Reilly did a good job of representing doctors. I accept the Opposition's claim that it is our problem we did not achieve a great deal for the State. Nobody wants to remove a benefit that has already been granted but we were asked at the time why wealthy people were getting medical cards. If I was wealthy, I would not sit in a queue to see a GP but would attend a private clinic. The problem was, however, that GPs were being paid irrespective of whether they treated their wealthy patients. This will not change anything for the people who will now be excluded from the system because if they are that wealthy they will have other ways of getting treatment.

The Minister of State noted that one in 20 elderly medical card holders will be affected. I ask her to confirm that this is the aim of the Bill. Some people would have us believe the medical card is being taken from everybody over the age of 70. Some sections of the media have been very unfair in the information they provided in this regard.

Ideally, I would love to provide everyone with free medical care. I am familiar with the system in the North and those of my constituents who have sought my assistance in regard to asthma and other health problems. Sometimes I receive representations from young families who do not qualify under the means test for medical cards. In these straitened economic times, we need to concentrate on providing services for those who most need them. Whatever savings we make should be used to increase the income threshold for those under the age of 70 because if the income limits for all are set at €700 per person, we can provide access to more members of our communities.

Those who claim that the cervical cancer vaccination programme was only going to cost €10 million are not telling the full story. The vaccine alone will cost €10 million but administering it will require additional funds. The Minister for Health and Children wanted to proceed with this programme in 2009 against the advice of the HSE, which claimed it would not be physically possible to implement it before 2010.

I represent an area in which four out of ten people are on waiting lists for treatment in four hospitals. Letterkenny General Hospital has one of the longest waiting lists in the country. The National Treatment Purchase Fund is available to anyone who has seen a consultant and is waiting for an operation. People should have confidence in using this scheme rather than be put off by the possibility that their own consultants may not perform the operations. One of the difficulties we must address in respect of access to services is the length of time people wait. Letterkenny has a very good hospital and I do not want it to get a bad name for long waiting lists. If a person has been waiting three or more months for an operation, he or she should contact the NTPF irrespective of whether he or she has a medical card.