Thomas Byrne (Fianna Fail) | Oireachtas source

Gabhaim buíochas leis an Aire Stáit as teacht isteach sa Teach le míniú a thabhairt ar an mBille seo. I welcome the Minister of State to the House to discuss the Health (General Practitioner Services) Bill 2015. The general effect of this Bill is to give back to the over-70s what has been taken from them, partially by the previous Government but mainly by this Government when it massively reduced the threshold on the over-70s medical card. The taking away of the automatic over-70s medical card was a major mishap by the previous Government in October 2008 and Fianna Fáil never fully recovered from that event, never mind the other events that followed. Following the public reaction to that measure, an extremely high threshold was put in place which effectively meant that everybody except the super-wealthy got a medical card at that time. There were probably too many people getting the card at that time and they included some very wealthy people. However, the threshold has been reduced dramatically since then, meaning many people over 70 on low to average incomes do not qualify for a medical card and did not qualify for a GP card before this Bill. Many of them have lost medical cards since the thresholds were brought in. Now they will all, including the super-wealthy, get free GP care. That is important for many people. We will not oppose this Bill but one has to question the logic of giving free doctor visits to some very wealthy people while some middle-income people with no children under six do not qualify for doctor's cards or medical cards, even in the case of extreme medical need. They are being left in the lurch because of this.

With the Minister of State present, we have an opportunity to look at what is happening in terms of the contracts that have been signed for the over-70s and the under-sixes. In my county of Meath, there has been a 29% uptake on the part of GPs with respect to under-sixes, and I am sure the figure is the same for the over-70s, and in Louth, it is 22%. In some other counties, it is very low while in others, there has been a high uptake, such as Donegal, Carlow and Kilkenny. Does that correlate with the fact that those counties already have a high number of medical cards? If a doctor already has a large GMS practice they are incentivised to provide the new services. If, however, a doctor does not fully depend on that, the incentive to do this does not seem to be very strong. I am very concerned that only 20 contracts have been signed in County Meath for the under-sixes and I presume it also applies to the over-70s. What will happen to those parents who need free GP care? Will they have to pay after July if they want to go to the doctor of their choice but who has not signed up? Will the Government fulfil its promise to them that they will get GP care free of charge?

The priorities have been wrong and we have not learned the lessons of the past. Fianna Fáil probably should not have given a medical card to everyone over 70 and should have put in a much higher threshold than the standard medical card threshold. Families with children would probably have benefitted more than the very wealthy over-70s. My family always seem to be at the doctor's but while we have been waiting for the Government to deliver on its promise to the under-sixes, two of them have gone past the age of six. We only have a year left and my own doctor has actually told me he will not be signing up anyway.