Darragh O'Brien (Fianna Fail) | Oireachtas source

It is good to see the Minister here again today, and he looks very relaxed considering what is happening in his political life. I wish him the very best in his endeavours. Senator MacSharry led out for our party on the issue. I have a number of issues and questions. The Minister will not get everything right immediately, and that is the purpose of debate. I welcome the reinstatement of medical cards, particularly to children. The Government acknowledged that the HSE made mistakes which caused much distress. I was glad to see that cards are being reinstated in my area. It is important we keep on top of that and ensure it happens. I support this legislation, subject to the assurance that people who are sick and require medical cards will receive them. Over the past two years, particularly since the review was brought forward, I have had grave concerns about this. Given that this is only Second Stage of the Bill, we will seek further figures on the number of medical cards that have been reinstated, which the Department will have.

The review of medical cards on which the HSE and the Department insist is, in many instances, a waste of time and money. While I have heard the Minister talk about this, and I agree with him, nothing has been done as yet. We are asking people who have life-long illnesses, ailments and disabilities that will not be cured to renew their medical cards. It must be a waste of capacity in the Minister's Department, particularly in the medical card unit. While I will not go into specific details of cases, every week I deal with numbers of people who will clearly retain their medical cards but who have to fill in the forms and send in the financial data. I see the Minister nodding and I am glad. I hope it will be addressed because we could save a lot of money, time, hassle and effort.

When people aged under 70 apply for a medical card there seems to be an insistence that they are applying for their families and spouses and the Department requires the spouses' financial data. In one case, a child aged over six years requires a medical card but the Department has asked for all of the data for all six people in the family. Again, it is a waste of time, money and effort. While we all want children and sick people to be able to access GPs for free, it is not really free; the taxpayer pays for it. Whatever we do, we must be fair to the GPs. I hope the new mechanism the Minister will use to discuss the draft agreement will be that. While there are certain constraints under legislation including the Competition Act, to insist upon items such as a gagging clause so that no GP who signs up to this can be critical of the HSE is ridiculous in a democratic country such as this. GPs who do not sign up to the scheme for the under sixes is being threatened with the prospect that medical card patients aged under six will be removed from them and the contract is for five years.

While I agree with all the HSE's stipulations to ensure the GPs' practices are up to scratch, GP practices will need to make a substantial capital investment to meet the requirements set down by the Department and HSE. While any GP practices that are limited companies or partnerships will be able to offset the requisite capital spend against future income, no grant is available. The Minister will know through his work that while everybody has the view that GPs are loaded, many of the GPs I know are not, particularly those who have started practices in the past five to ten years. Having invested heavily in their practices, buildings and facilities, many of them are heavily indebted.

It is about time somebody said that GPs are a very important part of our health system. In my area we have the D-Doc system, which works very well and provides a service 24 hours a day, seven days a week, 365 days of the year. The more people can be dealt with by GPs instead of attending hospital accident and emergency units, the better. We should take a step back on this. While I do not know who will be the Minister for Health next week, whoever it is needs to find a new approach to our GP services because this will not work without their approval and support, and we do not need to fight them. Under the previous Government, there was a serious situation regarding pharmacists, who had very serious concerns about issues such as dispensary fees. Over time, they were dealt with. We all want what is best for our citizens, but let us be fair to GPs. We do not need to hold up examples and say these people are minted and can take it on the chin. Many of them cannot, and we must support them.

I broadly welcome the Bill. While I take the Minister at his word, I do not know whether he will be in the same position next week. I do not mean this in any flippant way. Whoever is Minister needs to ensure fairness exists throughout the system. If he does not have the answer today, maybe on Committee Stage the Minister could report on the number of medical cards that have been returned to children and people with illnesses. Let us deal with the renewal of medical cards once and for all.

I have no idea why the HSE continues to insist that people with conditions such as serious epilepsy or amputees seek to have their medical cards renewed. It is a joke and a waste of money.

I thank the Minister of State, Deputy Alex White, for his presence and for his contribution this afternoon.