Paul Bradford (Independent) | Oireachtas source

I welcome the Minister of State. While I missed her initial contribution, I listened to some of it in my office and also listened with interest to the contributions of Senators John Crown and John Gilroy. I would not describe the measure as a small or big step backwards or forwards. It will regularise the position for the over-70s who, for a short period, had an automatic entitlement to a medical card before it was withdrawn and a means test system introduced. At least, we are back to a position of certainty for those aged over 70 years, which is to be welcomed. It is interesting that it is happening at approximately the same time as we are receiving the first strong projections on the take-up by GPs of the scheme for those aged under six years at the opposite end of the spectrum. Some of the difficulties in the scheme can be ironed out. Obviously, if the figure remains at 50%, it will be unsatisfactory. I hope further time and negotiations will help to resolve the issue.

Everybody appears to be at one in attempting to move towards some degree of universal health care provision. I have been here long enough to have heard all of the debates and proposals on the Canadian, Australian and Dutch models and sometimes one would think we were talking about a Miss World contest. There is general political agreement that we want every citizen to be fully covered by the provision of at least very basic health care. It has always struck me as unusual when we have had the great political debates on and divides about health care that, since the foundation of the State, whether due to political decision making or the scheme of administration we inherited from the British, we have had, for all its faults, a very basic but effective scheme of universal education. Every child has access, in the broad sense of the word, to free education at primary, secondary and now third level. If we can do it in education, we should be able to do it in the health care system. However, we have a long way to go.

Reading the briefing notes on progress in providing for universal health care and what has and has not happened since 2011, I appreciate that there have been many road blocks and that the final product may be very different from what was initially proposed a number of years ago. All of us together must try to ensure that, to use the phrase often used, the state of citizens' health should not depend on the size of their wealth. That should be our starting principle. I have never engaged very much in the debate on public versus private health care. As long as health care is provided, the provider does not concern me greatly.

Where does the scheme fit in in the move towards universal health care? Is it a component or a separate part? Senator John Gilroy also raised this question. Is it expected that in the next stage it will be rolled out to those aged under 12 years and over 60, for example? It would still be a welcome stand-alone solution to a problem. Part of the problem has been that the over-70s, for a limited period, had a so-called free medical card which was then withdrawn. That problem needed to be solved and this measure will solve it. Is it a separate resolution of that issue or an integral part of a universal health care model? I welcome it.If we can do it for over-70s and get GP buy-in, which appears to have been obtained, we can, I hope, manage it at the other end of the spectrum as well.

Many GPs have expressed to me in a fair and balanced way their strong concerns about some of the implications of the under-sixes scheme. Some feel simply that it is not fair that children, regardless of income, have access to care, while others fear the knock-on effects in their surgeries with the number of people arriving under the scheme. I hope the Minister and Minister of State are at least taking their concerns seriously. We must all recognise that if only 50% of GPs have signed up to a proposed national scheme, it is not a protest but rather a sign of problems which need to be addressed on an ongoing basis. As such, I welcome the legislation and look forward to the Minister of State's response to our observations.