John Gilroy (Labour) | Oireachtas source

I welcome the Minister of State to the House to discuss this technical amendment to the Health Act 2008. Even though it is only a technical amendment it is a fairly important one, not least in terms of the potential it offers to the Opposition to make mischief and scaremonger the very people they purport to protect. The temptation also exists for the Opposition to conflate, as Senator MacSharry has already done, this technical amendment with many other things that are happening in terms of reform of the health services, including free GP care for children under six and the many other concerns which people have about health service reductions.

As stated by the Minister of State, a safe, quality health service despite reductions in spending must be to the fore of everybody's mind. As identified by the Minister of State, the cost of the general medical services scheme is in excess of €2 billion per annum, which is an incredible amount of money. This €2 billion combined with the €3.8 billion, which as stated by Senator Burke is provided to the section 38 agencies, amounts to more than half the entire spend of the health service. This indicates the level and scale of the problem facing the Minister. If we cannot balance the books, savings have to be made. Regardless of from where savings in the bigger spending Departments are sought by Government, there will be pain involved.

Some 1.86 million people are now entitled to a medical card. This means there has been a 60% increase in this regard in recent years. As stated by Senator Quinn, 43% of the population of this country meet the medical card eligibility criterion. In 2008, the qualifying eligibility for a medical card was greatly expanded. Some people would say that the extension of eligibility for a medical card to all people over 70 years of age may not have been based on medical evidence. Some people would go as far as saying that there were perhaps other considerations foremost in the then Minister's mind that again were not based on medical evidence. We could seek evidence as to whether there is any support for that contention. I believe there might well be. The then Minister massively under-calculated the number of people who would be eligible, resulting in an immensely unplanned spend in this area. As stated by Senator Burke, planning and certainty are key in the delivery of any services. He also referred to other initiatives in respect of which a previous Minister did no planning, including the nursing home refunds scheme. When asked about this issue in committee, the then Minister put the blame on his officials. Current officials need have no fear in this regard as this Government will happily accept responsibility in respect of any planning undertaken by it, including any negativity arising in that regard.

Approximately 7% of those who are better off in Irish society will be affected by the change in the eligibility criterion for medical cards. Under this Bill, to be ineligible for a medical card a person must be in receipt of a pension of approximately €24,000. The threshold in this regard for a couple is €47,000. I understand that in this regard 35,000 people will be affected, which is a substantial amount of people. However, fairness being the underpinning value of everything this Government intends to do, it is fair, if unpalatable, to ask the better off in our society to contribute a little more. This has been said by Members on all sides. To say that the Government is reducing eligibility in this area is true. To say that it dislikes doing so is also true and to say that it is necessary is also true.

I look forward to hearing the Minister of State's Second Stage response and to engaging further with him on the Bill on Committee Stage.