Colm Burke (Fine Gael) | Oireachtas source

I welcome the Minister of State to the House and thank him for the work that he has done. I note there will be some changes but, in fairness, all of the Ministers at the Department of Health, Deputies Reilly, White and Kathleen Lynch, have been extremely innovative and hardworking in dealing with the Department over the past few years. There is a lot of work done, but a lot of work still to be done on the required reform.

On the amendments put forward by Senator Crown, it is important that we would have a debate on the important issues he has raised. I attended a GP meeting in Cork. There were over 350 GPs at it and they raised all of the issues that Senator Crown raised. It was of concern to them that a draft contract was put up online and there was an impression given that it was written in stone. I am glad that such a message has changed, that there is ongoing consultation and discussion with the IMO. In fact, I spoke with the IMO as recently as this afternoon and it confirmed that those discussions are ongoing, which is welcome.

On Senator Crown's amendment on not having any restrictive clause on contracts, I support what he is saying but do not think it is necessary to have it in legislation. If one tried to put that into a contract, any court would hold that where there is a valid public concern in relation to health care, general practitioners and medical practitioners generally are entitled to bring that to the attention of the general public and one cannot restrict people in any way from making public comment. I know of staff who work with the HSE and while they may have got warnings from HSE administrators that one cannot make public comment on issues, where there is an issue where it is important that the general public is aware of genuine health concerns then they are entitled to bring it to the attention of the general public.

It is also important that medical practitioners are entitled to debate and make available information to the public as regards why a particular service is having difficulties and why they are having difficulties in delivering a service, either through lack of resources or through lack of the necessary support staff. It is important that there is no restriction. While I would agree with what Senator Crown is saying, it is not necessary to put it into legislation.

Senator Crown referred to general practitioners. General practitioners have provided a superb service in this country over a long number of years. We need to acknowledge they make a considerable commitment and are dedicated, and provide a high level of care to their patients. Every GP I have ever dealt with has gone away beyond the call of duty in the level of care he or she provides to his or her patients. It is important, therefore, that in the introduction of any new scheme to expand the number of medical cards or GP-only cards there is full consultation with that group of medical personnel. I am delighted to see that the IMO, as a representative body of doctors, is engaged with the Department at this stage. The concerns general practitioners raise are listened to by the Department and the HSE.

One of the issues I want to touch on which is not covered by these amendments is an issue on which I published a Bill, namely, the requirement of all medical practitioners in this country to have insurance. I am not clear whether or not we are writing that into the contract that is now being provided. While one cannot drive a car on the road without having insurance and I cannot practice as a legal practitioner without having insurance, there is still no legal requirement on medical practitioners to have insurance. I suppose it is not really a big issue in the case of general practitioners as such.

Where it is a real issue is in relation to those who are providing cosmetic surgery, particularly where staff are coming in from abroad to provide it. We still do not have such insurance legislation in place. The Bill I published seems to have been parked and we do not seem to have made any progress on that over the past two years. The Minister, Deputy Reilly, introduced his own Private Members' Bill in 2009 and here we are five years later and we still do not have that legislation in place. It is something that should be given priority. A requirement to have insurance is certainly something that should be put in place as a condition in contracts for GPs. I am not too sure whether or not it is included in the existing contracts but it certainly should be introduced.

The other issue I wanted to raise with the Minister of State relates to services being offered by GPs. I understand there is a difficulty where some practices began to offer scanning services. I discussed with the MPS and other insurers who provide insurance for GPs whether this service is covered by normal general practice insurance. It is also something that needs to be looked as there is a growing number of practices offering scanning service. It is a welcome development, but it is also important that there is adequate insurance cover for them and that they fully understand that their insurance policies provide such insurance.

I welcome the decision by the Government to provide free GP care for those under six years of age. While there has been much criticism of it, there are many young families which are falling into the trap where they find it difficult to get private health cover and do not qualify for medical cards. This is one development which is welcome, especially to give support to those who have young children so that they have access to medical care when they require it. I certainly hope that the consultations and discussions with the IMO come to a satisfactory conclusion and that this scheme can be started at the earliest possible date. I thank the Minister of State for bringing forward this legislation.