Colm Burke (Fine Gael) | Oireachtas source

I welcome the Minister of State to the House. This Bill amends the qualifying criteria for medical cards for the over 70s, but it needs to be put in perspective, in that, when the scheme was introduced, there were free medical cards for everyone aged over 70 years without a consideration of the cost. Nursing home care was one such cost. As far back as 1976, the Maud McInerney High Court case defined nursing home care as falling under the qualifying criteria for medical cards. Therefore, if one had a medical card, one was entitled to free nursing home care. As a result, the introduction of the medical card for all over 70s created problems, in that it subsequently led to the Department needing to pay out nearly €500 million in the refund of nursing home charges.

My colleague on the other side of the House, Senator MacSharry, has referred to the hit and miss approach to adjusting policy. We want to introduce a planned policy over a number of years. We are putting in place a regulation covering the qualifying criteria for people with incomes. It is not about removing medical cards. People have an entitlement to a GP card.

Another issue that has been left out of this debate is the cost of medication. A major effort has been made in recent months to reduce the cost of generic medicines. The situation that used to obtain showed the unplanned approach that had been adopted in the preceding ten years. Some 18% of our pharmaceuticals are generic, whereas the figure in other European countries is as high as 70%. The cost of medicines has been unrestricted for a long time. If someone has a GP-only card, the maximum price that he or she must pay is €144 per month, after which he or she is entitled to a refund. It is important that we keep this in mind. It is not the case that every item a person gets for free will suddenly start costing the full amount.

Since the Government entered into office, 254,000 additional medical cards have been issued, increasing from 1.7 million, including GP-only cards, to 2.001 million in June. This figure has changed somewhat in the past two or three months, but it is a significant number, representing 43% of the population.

Some 35,000 people will be affected, but 49% of the population will have a medical card or a GP-only card after we introduce the GP-only card for children aged under six years. This is a significant step on the part of the State. Despite the economic pressures, we can look after people who no longer have the level of income that they previously enjoyed. We have been decisive in giving this level of support in recent years. We have specifically set aside €37 million to budget for the cards for children aged under six years.

The Department of Health has taken all of the right steps in the past two years. One cannot change budgetary management overnight, but significant efforts have been made, particularly in the past 12 months. In an unplanned way, we allowed the cost of drugs to increase from more than €570 million in 2000 to more than €2 billion a year ago. Now, a serious plan is in place to reduce the cost of medication and, therefore, the cost of health care for the taxpayer, allowing us to increase the level of services provided.

The Bill is a step in the right direction and ensures that we take a planned, rather than piecemeal, approach. A mistake was made between 2000 and 2010, in that many policy changes did not form part of a planned approach. We have set out our health care plan for the next five to ten years. It is a question of achieving changes.

A point I highlighted at a meeting of the health committee has since taken on a life of its own. I raised it on 17 October, having submitted a question in September. It concerns the budget we are paying non-HSE and non-departmental organisations, which amounts to €3.27 billion or 25% of the overall budget. This expenditure has not been subjected to significant scrutiny during the past ten or 15 years. It is as if there were no limits. Now, the Department is examining it carefully. Last week, I tabled an Adjournment matter at which the Department again confirmed that it had written to the section 39 organisations asking them to comply with pay policy so that the same levels of pay might apply in those organisations as apply to equivalent posts in the HSE. This welcome development shows that the Minister of State, Deputy White, his colleagues, the Minister of State, Deputy Kathleen Lynch, and the Minister, Deputy Reilly, and departmental officials are dealing with the health budget in a more planned and structured way. As a result, there will be a benefit for the taxpayer and people who are entitled to supports. We will also be able to expand those supports.

I thank the Minister of State for attending, for introducing this legislation and for ensuring through it that the most vulnerable, for example, people with low levels of income, are looked after.