Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I thank all Senators for their valuable contributions, support and positive criticism and new ideas. This is an important Bill. Its provisions will be a welcome development for two groups of people who have additional medical needs - children with disabilities in receipt of the domiciliary care allowance and those aged over 70 and their dependants. Children in receipt of the domiciliary care allowance have a severe disability and require ongoing care and attention substantially over and above that required by children of the same age. The legislation will mean all children in respect of whom a domiciliary care allowance payment is made will automatically qualify for a medical card and, therefore, will no longer be subject to the medical card means test while in receipt of the allowance. As I stated earlier, I fully recognise the added stress parents and guardians are faced with when dealing with a difficult diagnosis. For many it is their first time to seek assistance from the State. Providing an automatic medical card to these children will reduce the uncertainty and anxiety they face in accessing the services required, as well as lessening the financial burden associated with managing their child's disability. I understand the new scheme will be live from 1 June and that the parents and guardians of those children who do not hold the medical card will be able to pre-register with the HSE from 1 May. The Senators are correct we need to get this message out to the families.

Another of the Government's commitments is to reduce the cost of medicines for Irish patients. Budget 2017 included a commitment to reduce the prescription charge for medical card holders aged over 70 years of age and their dependents. This legislation addresses this issue. I welcome the introduction of this measure as it will provide some relief for those aged over 70 and their dependents. In general, those aged over 70 have higher rates of medicine usage and therefore are most impacted by the prescription charges.

Senator Horkan stated more can be done, and I accept the point, but it is a start. He also spoke about the timeline, which is to roll it out on 1 June. He also raised a very important issue, about which I feel very strongly myself. This is cancer and the debacle people face when they are under severe pressure. I agree with the Senator and we will push it. Another important issue he raised is primary and GP care and services in the community. Recently, I met a group of GPs in my office who made this point. They strongly emphasised the GP contract and the ethos of primary GP care as a major start in developing a health service. These are the ideas I have and these are the ideas I will implement.

Senator Victor Boyhan spoke about our senior citizens and the issues raised by Age Action, and we will need to deal with these. He mentioned the cap with regard to lone pensioners. He also asked about what will happen to 16 year olds. At present, there is a half rate domiciliary care allowance payment. These children will receive full medical cards. Between 16 and 18 years of age those with a recognised disability will receive medical cards, and this is something I want to push. I emphasise that while we are doing these reforms my objective is to ensure every child in Ireland with a recognised disability or long-term illness gets a medical card. These are the types of changes I want to implement. Senator Boyhan mentioned the United Nations Convention on the Rights of the Child. He asked whether we have plans for those aged under 70. We have many plans but we have not developed them yet and I will come back to Senator Boyhan on these issues.

Senator Colm Burke raised a number of important issues. One of these, about which I feel very strongly, is respite care for children aged over 16. As Minister of State I have been going up and down the country meeting families. They seem to be grand with respite for children aged up to 16 but then it disappears for a while. I am determined to push respite services. In 2017 I plan to ensure we will have 41,000 day respite sessions and 2.7 million home support hours for 7,500 people. There are gaps in the system and we need to focus on this issue.

Senator Máire Devine spoke about the campaign group Our Children's Health. I know the group, which has been campaigning for many years. I acknowledge its contribution to the debate. Its objective is the same as mine, which to ensure children with disabilities and sick children get their rights. The Senator also strongly emphasised the importance of community action. What saddens me about modern society is there is not enough community action. We need more community action coming from people on the ground. When I go to second level schools and meet transition year students I am always blown away by how interested they are in current affairs, human rights, disabilities, having a proper country and honesty in politics. There is a buzz in classrooms throughout the country but when they reach the age of 18, 19 or 20 we seem to lose them. We have a job as politicians to develop this. We must also highlight and publicise the difficulty in accessing medical cards and services.

Senator Byrne spoke about the pain of families and asked whether we could examine other ideas and allowances. We must look at this. In this year's social care and disability service plan we are looking at these issues. We managed to obtain approximately €16.2 million for a plan to develop home support for these families who are under severe pressure. We must look at other ideas and I intend to do this as part of my ministry. I also intend to work very closely with the Ministers, Deputies Leo Varadkar and Simon Harris. The Minister, Deputy Varadkar, has many ideas in social protection to assist families.

Senator Nash spoke about the process and direct communication, which a number of other Senators also mentioned. He stated we must ensure nobody is left out and that everybody is covered, and that we should keep an extra eye out for less well sections of society.

Senator Reilly mentioned the additional challenges for families of people with disabilities. He has been a long-time campaigner, when in government and as a Member of this House, of the idea of cost-effective primary care and free GP care to reduce costs and reduce issues in our accident and emergency departments and hospitals. The general practitioners I met last week also emphasised this point. We all speak about the fact the health service is short 3,000 beds but they argued if they had proper funding and support for primary and GP care and early intervention services there would be less need for beds in hospitals. This is a cost-effective argument to which I listened.

Senator Buttimer spoke about the most needy and access. As long as I am Minister of State, my focus will not be on the HSE, the Department of Health or myself but on the person with the disability. I want to design services around people with disabilities.

I accept the point that some people might consider the reduction in prescription charges to be modest, but given the resources available in the health system it was considered the most effective use of these resources to apply the reduction to the cohort of the population. I am happy to note this measure was implemented on 1 March.

I thank all Senators for their support of this important legislation. I will come back to them with details and more up to date information on some of the points which I did not get to. We are reforming the disability allowance as well as the domiciliary care allowance and the Senators will need to be updated on this. I thank them for their contributions and I look forward to further examination of the Bill on Committee and Report Stages.