John Crown (Independent) | Oireachtas source

I welcome the extension of the provisions to the over-70s. It is overdue and while it is, as the Minister of State has said, a step along the road, it is a very long road and a lot needs to be done. I am not happy that the basic tenet on which the Government was elected, namely fundamental reform of the health service, is not being honoured. I do not wish the Minister of State to take that personally. The Minister for Health made a public commitment to making those fundamental reforms, yet soon after assuming office he stated that they would not happen within the first term of Government but in the second term. It then became apparent that there were major administrative impediments, and it looked like the Government was swimming through treacle.

The Bill provides for a restoration of something that was there previously, in what was generally recognised to be a fairly bad health service. I understand this is a step along the way and do not want the Minister of State to think I am being unduly critical. The Bill is bringing the service back from a real nadir of deprivation to where it partially was prior to the economic decline.

We need to keep our eyes on the prize. A lot of very good things are happening at the scientific end of medical research right now. We are going to face incredible challenges in paying for new treatments and will have patients who are living long enough to get them. We will also have patients living longer as a result of receiving those new treatments. Unless we do some proper forward planning of how we are going to structure the health service, we are not going to make much progress.

With regard to this legislation, I know from dealing with many patients that it was a cause of pain and anguish to people that they thought they were losing and, in many cases, did lose, their medical cards. It was a source of extreme annoyance and worry to people who had other things to worry about at their age, including their health. I am glad they are at least being relieved of this one little worry. With the co-operation of our very fine body of general practitioners, who keep the whole system ticking over in difficult circumstances, I hope the Bill will have other spin-off effects, such as decreasing the pressure on the emergency rooms.

Without seeking to be too dramatic about it, the situation in emergency rooms around the country in this last week has been terrible. I had occasion to visit one of them several times and to speak to doctors working in another. It is as bad as it has ever been. I am not sure the metrics the Minister of State is getting are reflecting the reality of what we are seeing. One or two of my own cancer patients had to engage with the emergency services and, despite what they acknowledged were truly heroic efforts by the staff, they did not get a standard of care appropriate for a modern western country. I have to be careful how I say this. I was in one emergency department during the week that I thought would have trouble passing a fire inspection. What should have been walkways through the department were blocked by doubled-up trolleys. There was not just one trolley against the wall but a trolley against the wall and another trolley against that one. Moving one trolley from one part of the department to another involved moving someone else's trolley as well.

There has been a little step along the way today and a little box ticked for an election promise but we have a long way to go. Somebody else once said, "A lot done, more to do". In this case, it is a little done and an awful lot to do. Let us do it.