Alex White (Dublin South, Labour) | Oireachtas source

The move to centralise under the Primary Care Reimbursement Service, PCRS, has had a beneficial effect on the way the system is being administered. Some Senators are shaking their heads. As diligent public representatives, individual cases present to them. I have examined some cases, as I have also been approached. I have taken Adjournment debates and parliamentary questions. We have considered many of the issues that have been raised, but the backlog of people awaiting decisions on, for example, discretionary medical cards, the issue that concerns people the most, has reduced substantially. The target turnaround time for discretionary medical cards is 20 working days. However, if a Senator has an experience that causes him or her to disagree with my comments on the great progress being made, it should be brought to our attention so that it can be addressed.

I wish to address the commitment in the programme for Government to universal access to GP-only medical cards. It remains a commitment to ensure it is done before the end of the Government's term of office. We pointed to a particular route. The programme for Government referred to addressing the long-term illness scheme first, high-tech drug users second and, third, a form of subsidised GP visit cards. That was our aspired route to a destination, although it is not the route now being taken.

I have dealt with the issue before in this and the other House. We are currently examining a different route, which is to extend GP visit cover to persons with certain chronic illnesses. That does not refer to people on the long-term illness scheme but rather people with certain demonstrated chronic illnesses. This chimes with a general population health approach to primary care and it is the route we are currently considering.

I emphasise that we will get to our destination and it is absolutely our commitment to extend GP visit cards and free GP care to all of the community by the end of the lifetime of this Government. That is the intention and very much what I am dedicated to achieving; the biggest priority I have as Minister of State with responsibility for primary care is to make this happen. That will not come without difficulty or complication. The Health Act 1970 is based on extending medical cards to people based on income and financial or material hardship. For example, having a chronic illness would mean a GP visit card would have to be extended on the basis of a particular illness rather than income or hardship, which is a different conceptual issue and not without legal difficulty. That does not take from the strength of our commitment to reach the destination of universal GP care by the end of the lifetime of this Government.

The Minister for Health and I still hold to the universal health insurance commitment in the programme for Government. We did not say we would be able to achieve universal health insurance within the life of this Dáil but we would do so by the end of the next Dáil. We have much work to do on the precise model to be put in place, which I accept, but universal primary care is a necessary prerequisite of universal health insurance. That is the objective to which I am most closely dedicating myself while working with the Minister for Health and the Government to achieve the broader agenda of universal health insurance in the coming years.

I am almost exactly six months in this job and one discovers certain frustrations in public life, policy and administration. Nevertheless, I do not doubt the close dedication and commitment of public servants across the board, in the Department of Health and in the HSE. This is a period of major change and reform and the process takes longer than one may hope. That does not diminish our commitment or set us back in the least from what we need to achieve in the shape of true reform and a much-improved health service available to people on the basis of need rather than income.