Joe O'Reilly (Fine Gael)

Ar dtús báire, ba mhaith liom fáilte a chur roimh an Aire Stáit go dtí an Teach agus go dtí na díospóireachta tábhachtach seo i dtaobh cúrsaí sláinte.

When the social history of the 21st century is eventually written, the removal of medical cards for certain people over 70 will be seen as iniquitous and an unmitigated disaster. This represents a terrible attack on those older people who paid 60% tax, who educated themselves, who lived through the scourge of emigration and the bleakness of the 1950s, who endured many hardships and who did not have access to the opportunities we enjoy. It is wrong that those people were targeted. It is equally wrong that the initial scheme was introduced in a politically opportunistic fashion, in the absence of proper negotiation and as an election gimmick. The origins of this tragedy lie in the fact that proper negotiations to ensure that the scheme was established on a rational basis and, perhaps, in an incremental form never took place.

The fact that wrong was done initially does not justify the visitation on people of an even greater wrong. If, on my way home this evening, I were responsible for causing a minor car accident, I should not seek to solve matters by extricating myself from the first incident and then causing an even greater one. What the Government is doing is an unmitigated disaster and it represents an unjustifiable assault on young people.

Fine Gael is approaching this matter on the premise that, in government, it would establish a universal health care system. We believe in the concept of universality in the context of the health and education systems. We will establish such systems when we are returned to Government. We are working on the details relating to these systems at present.

I do not accept the Government's proposition that ultimately only 20,000 of the 140,000 people over 70 who have medical cards will be affected by this measure. I remain to be convinced that this is the case. I hope the Minister of State will be able to uphold the validity of the figure to which I refer.

Little information has been provided in respect of the means test. The income level will not be index linked. That is a matter of critical importance. It is also critical that the means test should be based on gross income. We must reward those who worked hard for many years and who, by exerting the greatest of effort, accumulated a little wealth in the worst of times. When one examines the position of a person with an income of €700 per week and factors in that he or she will have a tax liability, exclusive of PRSI, of €5,530 per year, one comes to the conclusion that he or she will have a net income of €595 per week and that his or her card will be removed.

People will be allowed to have savings of €36,000. For many of the elderly, that figure is not significant. What will be the position of those who have down-sized and sold their family homes, who sold their prime residence before entering nursing homes or who accumulated properties in different locations in the interests of providing their children with accommodation? Will there be no justice for those people, with integrity and honour, who paid tax at the highest rates in the worst of times?

It is neither proper nor acceptable that, in a 21st century republic, retired teachers, gardaí and public servants should be deemed to be ineligible for medical cards. What is the position with regard to living expenses? I accept that they decreased somewhat in recent weeks but the cost of fuel has been escalating for some time. What will happen to people who will be expected to pay exceptionally high nursing home bills out of a weekly income of €595? There are many variables and unknowns in respect of this matter because the scheme was developed on the hoof. That was the wrong way to proceed.

The level of relief in respect of health expenses was reduced in the budget. Such relief used to be paid at the 41% rate but from now on it will be paid at the 20% rate.

There is a very interesting aspect that arises in respect of this matter. The Minister for Health and Children stated in the Dáil that she would accommodate people with cancer and those in special circumstances who are required to cope with exceptional expenses with discretionary medical cards. That is fair enough. However, the budget relating to discretionary medical cards has been frozen and there has been no indication that it will eventually be increased to accommodate those who require such cards. Therein lies a difficulty.

The point made earlier that people visit their doctors, community medical services, physiotherapists, occupational therapists etc., more often by virtue of having a medical card, which is an ultimate saving to the economy, is important. If a person has an income of €595 a week, substantial living expenses and is the type of person who is thrifty and has saved €36,000 or a fraction thereof, that person will visit his or her doctor less often. Ultimately, that is bad for the person concerned but it also creates an additional cost on the system, which is a serious concern.

My fundamental proposition regarding this measure is that rather than trying to patch what was clearly an error of gigantuan proportions, it was best to admit the error in a manly fashion — people would have accepted that — reverse the position and focus, as we suggested, on the reduction of the doctors' fees and the cost of generic drugs. Also, all parties in this House should accept and move towards adopting the principle of universality.

We know there is a need for cutbacks but we must all affirm, collectively, on this Friday on the eve of Christmas, in the Republic of Ireland, that we will not repeat the unmitigated errors of the past 11 years on the backs of the old people of this country. My mother is 88 years old. I am very proud of her and I am horrified that people like her would become the victims of our idiocy over generations. Are we to correct the ills of the past on the backs of women like her who worked in the worst of times? The Minister should think about that.