Jillian van Turnhout (Independent) | Oireachtas source

The Minister is welcome to the House, as always. I very much welcome this Bill. I will try to restrict my comments to the Bill and its intention, which is to provide GP cards to all children aged five years and younger without fees. I acknowledge there are many competing demands in our health services but I will not play one off against the other.

What we learned from the medical card crisis, or whatever term different parties give it, is that each story gave us an insight into the ensuing distress for individuals and families. I do not stand over any of the withdrawals or the lottery-type system but believe that what occurred very much shows how we need a health system that is transparent and based on rights. That is what we are trying to do today.

Giving free GP cards to all children under six is the first step in taking a rights-based approach to health care. Article 24 of the UN Convention on the Rights of the Child states the child has the right to the enjoyment of the highest attainable standard of health possible and to have access to health and medical services. In giving free GP cards, we are proceeding in line with General Comment No. 15 of the Committee on the Rights of the Child, which calls for universal coverage of quality primary health services. The World Health Organization has identified that the aim of universal health coverage is to ensure that everyone can use the health services they need without risk of financial ruin or impoverishment.

GP care is often the first point of contact with our health system. Illness is not a planned activity and families can find they have one, two or even three unexpected doctor visits in one month. It is not something any of us can plan. The cost of visits to the GP along with prescription charges and other associated costs can be significant and very often move families dangerously close to the at-risk of poverty threshold or even push them beyond it. With so many pressures on family finances, a small health concern may be postponed until it becomes a significant health issue. A report on medical card entitlement highlighted that parents, particularly mothers, neglect their own health because of the expense and related costs of GP visits. When it came to spending decisions, children were their priority.

GP care is the cornerstone of a successful health service as highlighted in the Children's Rights Alliance report card in 2014. It is the first point of contact with the health system and we must ensure that it is resourced, effective and making the connections. We have seen in the study on growing up in Ireland how important access to GP care is. My concern is that where a child gets access to GP care, he or she may still have to wait a long time before seeing a consultant. We have certainly seen that those living in more socially disadvantaged areas are less likely to go to a consultant or obtain further treatment. While I welcome this move, I wonder if it will show up other areas of stress in our health system.

We must note the cumulative impact of six tough budgets which have pushed many parents to their limits. We must give hope to families and communities. The survey last week by Pfizer - the health index - found that 69% of people are still finding it difficult to make ends meet while 81% did not see that their current level of disposable income would improve during the year. The majority of those surveyed were very welcoming of the new free GP card.

I have a question about equality of access. We must ensure that all children benefit, especially those who are less likely to link in with the same GP on a regular basis. This was raised in the Children's Rights Alliance report card, which set out the example of Traveller or Roma children as well as children who live in direct provision accommodation. We must ensure we do not just link into our child benefit register or PPS numbers as those systems exclude many of these groups of children. I want to be clear that the Bill is for all children in Ireland irrespective of their status and that the habitual residence condition will not apply.

I welcome the Bill. While I realise the pressures that are on the health service, this is a rights-based approach and a welcome first step towards universal health care. I support the Bill.