Gerry Horkan (Fianna Fail) | Oireachtas source

I welcome the Minister of State to the House. I will be speaking on behalf of my colleague, Senator Swanick, who is unfortunately unable to be here today.

I welcome the opportunity to speak on the Bill as it was a specific commitment in Fianna Fáil's 2016 general election manifesto. Fianna Fáil supports this Bill which provides a medical card for all children in receipt of the domiciliary care allowance. We are also committed to the removal of prescription charges on a phased basis so we welcome the reduction for the over-70s.

In the Dáil and Seanad during the term of the last Government, Fianna Fáil was to the fore in highlighting the Government's targeting of people on discretionary medical cards, especially from 2012 to 2014. I appreciate the Minister of State was not part of that Government. The subsequent U-turn and climb down by the Government was testament to the strength of our opposition on this issue. More can be done, especially for children with disabilities, which is why we included a proposal in our 2016 general election manifesto to provide a medical card for all children in receipt of the domiciliary care allowance.

At the moment, there are around 10,000 children - the Minister of State referred to 9,800 - who receive the domiciliary care allowance but are not in receipt of a full medical card and are forced to pay for medical care that is not covered by this scheme. The Bill will provide all 33,000 domiciliary care allowance recipients with full eligibility for a medical card. While this is very welcome, will the Minister indicate the timeline for the roll out? We also made it a provision in the confidence and supply agreement with Fine Gael that the more humane system for discretionary medical cards that was put in place prior to the election would be fully maintained after polling day. It remains imperative that we ensure that those experiencing financial hardship due to very serious illnesses will receive a discretionary medical card. We should never forget the appalling denial and deceit from the then Government over discretionary medical cards in 2013 and early 2014. It is extremely regrettable that thousands of families across the country were put through the stress and hardship of having their medical cards withdrawn before the Government finally saw sense in mid-2014. For two years the Government ignored the issue and denied there was a deliberate policy to cut discretionary medical cards. It was only in the wake of public outrage and backbench panic that it finally acted. Fianna Fáil will continue to ensure that the more compassionate and humane approach to medical cards is sustained.

The programme for Government also contains a commitment to request the clinical advisory group on medical cards to examine the guidelines for the awarding of discretionary medical cards to patients undergoing treatment for cancer. That is something we welcome and on which we want to see action. As the Irish Cancer Society has pointed out, many cancer patients and their families face a financial crisis while they are going through their treatment. The 2015 report, the Real Cost of Cancer, showed how a significant number of patients face a severe drop in income while at the same time running up extra bills on a range of items such as home heating, parking, child care, travel, prescription charges, hospital stays, over-the-counter drugs, consultant visits, dental care, physiotherapy and clothing and personal care. A medical card is designed to be available for those who are suffering financial hardship as a result of their illness and from the Irish Cancer Society's research we can see that more than 20% of survey respondents who applied for a medical card after their diagnosis did not get one.

I welcome the changes to prescription charges in 2011. The then Minister for Health, now Senator James Reilly, declared his intention to abolish prescription charges. However, within 18 months he performed a spectacular U-turn, trebling the 50 cent prescription charge to €1.50 and in budget 2014 he compounded his hypocrisy by adding another euro to the charge. That was a deplorable breach of faith by the then Minister and has taken hundreds of millions from the most vulnerable in society. The increase in prescription charges is having a disproportionate impact on fixed-income groups, in particular pensioners. Fianna Fáil is committed to the abolition of prescription charges on a phased basis as the cost makes it prohibitive for people to access medication.

Health care professionals have consistently described the charges as short sighted, potentially resulting in more people having to be hospitalised when that could have been avoided through primary care, which ultimately only increases the cost of health care for the State. The Government claims it is seeking to help low and middle income families. However, medical card holders who by their nature are some of the most disadvantaged in society are still paying up to €25 a month for vital medicines.

When the provision of medical cards is discussed, the issue of free GP care always comes up. Fianna Fáil is committed to making primary care stronger and embedding it as the first point of contact in health care. We want to expand GP care on the basis of income rather than age, yet at the moment nobody in government or opposition can definitively say how much that would cost. We must bear in mind how the original estimate for free GP care for the under sixes doubled following the agreement of a contract with GPs in April 2015. Therefore, before we proceed any further in that regard, Fianna Fáil wants to see a GP contract in place which has general practitioners on board for universal GP care.

The Bill is a welcome measure for those in need. However, we must ensure the smooth passage of the Bill through the legislative process so that those measures can be put in place without further delay. I will withhold my congratulations at this point until all recipients of the domiciliary care allowance receive their medical card.