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

It is my pleasure to introduce the Health (General Practitioner Service) Bill 2018 to the Seanad. I was pleased last December when the Government announced that eligibility for a general practitioner, GP, service without fees was to be extended to all people in receipt of a carer's allowance payment. Following further examination of the proposal, the Minister for Health, Deputy Harris, confirmed in April that this measure should also be extended to persons in receipt of carer’s benefit. The purpose of the Bill, therefore, is to provide a general medical and surgical service free of charge to persons in receipt of either carer’s allowance, both full rate and half rate, or carer’s benefit. This Bill will result in approximately 14,000 additional people being eligible for a GP visit card. It will enable them to access vital GP services without having consider their ability to pay for the service.

Becoming a carer for a loved one is a life-changing experience. Each day can bring new demands, new highs and new lows. The 2016 census noted that over 195,000 people, that is, 4.1% of the population, provided unpaid assistance to others. This amounted to a total of 6.6 million hours of care per week. Some of this care is provided on a 24-7 basis by family members or unpaid carers. Carers come from different walks of life and enter into their caring responsibilities at different stages in their lives. Their reasons for beginning this journey, however, are the same. They are all motivated by their love for the person they are looking after and they also have an expert knowledge of the person that no one else could have. While there are many positive and rewarding aspects to caring, it can also place physical and emotional demands on carers who are trying to balance their own well-being with the needs of those for whom they care.

It is also recognised that being a carer can have financial consequences, with many carers having to either reduce their working hours or even give up work entirely. This is, of course, often done unselfishly but nevertheless it is important to recognise that this can create a burden on carers in a variety of ways. In recognition of the significant contribution and commitment that family carers make and the concerns they face, the Government developed Ireland’s first national carer’s strategy in 2012. The strategy sets the strategic direction for future policies, services and supports provided to carers by Departments and Government agencies. On healthcare, the strategy recognised the need to support carers in maintaining their own physical and mental health.

We do recognise, however, that both time and money constraints can sometimes make this very difficult. The question often asked is, who cares for the carers? There is no doubt they need and deserve acknowledgement, understanding and support from their fellow citizens and from their Government. To that end, a number of initiatives have been progressed in recent years to aid carers. These include increases of €5 in the social welfare payments made to carers in budgets 2017 and 2018 and an extension from six to 12 weeks for the continuation of these payments after the death of a person who was cared for or his or her entry into residential care. This has gone some way to ease the financial burden on the shoulders of carers.

Last December, it may be remembered, an additional investment of €10 million in respite care services was announced. This will deliver greater provision in respite care for people with disabilities, enable more carers to take a break from the daily caring routine and provide them with much needed time to maintain their own health and well-being. The provision of a free GP service is another important milestone in the Government’s continued support for carers. It is another major step. The provision of high-quality GP care, centred on the needs of carers, is essential to ensure that carers' own health does not deteriorate. This is particularly the case because we know that their health tends to deteriorate gradually as their hours of caring increase over time. The Health Service Executive has indicated that carers will be able to apply for a GP visit card from 1 September 2018. If we do this today, we can move fast. Applicants will be facilitated to make either a paper or online application.

The provisions of the Bill are straightforward and I will outline the main provisions. Section 1 provides the relevant definitions, section 2 provides that the HSE’s appeals process be extended to encompass this service and section 3 provides that the HSE’s current "ordinarily resident" framework be extended to this new service. Section 4 provides for a GP medical and surgical service to be provided free of charge for persons in receipt of either carer’s benefit or full or half rate carer’s allowance and for the assignment of a GP of choice, where practicable. That enables the HSE to request the necessary documentation from applicants to establish if they are, or continue to be, eligible for this new service. Section 5 of the Bill provides for the Long and Short Titles of the Act and the relevant commencement provisions.

All of us will be touched by caring at some point in our lives and that is the experience of most Members of the Seanad and Dáil, whether we take on a caring role or need care ourselves. For me, this Bill is about looking out for people who spend their time looking out for others. Caring for those in need provides a major contribution to health and social care in Ireland. Our Government recognises the major contribution carers make to the welfare of others and we aim to strive for a society that respects, values and supports these carers. The needs of carers are being considered across Government and I would hope that we will receive cross-party support on this important legislation. To conclude, I am pleased to bring forward this legislation. I take this opportunity to stress the importance of enacting this legislation before the summer recess in order that this service can be in place for carers in September.