Victor Boyhan (Independent) | Oireachtas source

I warmly welcome the Minister to the House and I wish him well. I thank him even for the clarity and delivery of the content of the Bill.

The first time I spoke to the Minister it was not in Ireland. The first time I met him and had a chat with him was in the company of the current British Prime Minister, Boris Johnson, when we were on a trip to the UK. Boris Johnson came a bit late and offered us some refreshments. I think he suggested tea and we might have suggested something else. Anyway, he immediately picked out this red-headed fellow in the back. It was only a few years ago. He said that this was one smart guy and that he had worked with him when he was Mayor of London and the Minister was involved in consultancy. I had forgotten that and while sitting here I looked over at him and remembered that incident. He was very decent. He set up a few photographs of that evening in Whitehall. He said he was a smart guy and I believe he was right. I would not necessarily have much in common with the key themes and messages the British Prime Minister discusses from time to time.

I thank the Minister for his clarity of message. We are in for an exciting time in health. From what I have observed of him, from what I have heard about him and from what colleagues inside politics and outside politics have said about him, he is extremely professional and focused. Some might say he is over-focused, but that is what we want. This is the person we want in the job as Minister for Health. I very much welcome the Bill which when fully enacted will extend free GP care to children up to the age of 12 and increase the access of medical cards for persons aged 70 or older. The expansion of GP care without charge is an important health measure in line with the Government’s stated objective. However, it was the stated objective of the previous Government and we need to remember that Fine Gael has been in government for nine years. This is another extension of the previous Government, albeit with other parties. Let us not lose sight of where we have come from and the continuous stated objective and how long it has taken us to get there. However, it is positive that it is happening now on the Minister’s watch for which I thank him.

It is also a key objective of the Sláintecare implementation plan. Sláintecare will be a recurring theme for the duration of the Minister’s Ministry and well into the future of our healthcare system. We should never lose sight of the fact that where there are new reforms in health, we need to keep referencing them back to Sláintecare. Sláintecare has support across the House, both inside these Houses and in the greater health community.

As the Minister has said, the Bill provides a legislative framework; it will not all happen at one time. He has set out phases 1, 2 and 3 very clearly. I was going to ask him a question about that, but he has set it out here for me, so I do not have to ask him that question. It is important that we should say it is a legislative framework to get things done.

The Bill also provides for the implementation of an increase in the weekly gross medical card income limits for those aged 70 and older to €550 for individuals and to €1,050 for couples, which is currently €900. That is an increase, albeit moderate, and the Minister has clearly set it out. That is the sort of clear message without ambiguity we need. We want to clearly set out where there are benefits and we need to get the message out that these are benefits.

The legislation will significantly improve access to GP services for children and also increase the number of those aged over 70 who have access to medical cards. It is a framework, as the Minister has said. As Senator Fitzpatrick said earlier, it is about access to GPs. What is the story here? We know that with Covid, GP services are closed down. We know people need to make appointments. We know that people are waiting for up to ten days to get access to their GPs. We know that many people have left the medical services. We may have potential access for GPs, but we know that in many areas there are no GPs. I had contact from people in Blackwater in County Wexford, where the residents were begging a GP to stay because there was no other GP in the public system.

We have a problem. On the one hand we are talking about increasing access for different age groups. As the Minister said, we want to break down barriers for access to the health services for children. It will take time before we have the full roll-out of phases 1, 2 and 3 up to 12. Hand in hand with these measures we need to identify why so many GPs are leaving. Why do so many people find it unattractive to be in general practice?

How can we embrace new technologies in our health services? How can we expand the offering of the services? I had the experience of bringing someone to SwiftCare in south County Dublin. The person was in, looked at, X-rayed and out in 30 minutes. The private sector has led in this area. I do not necessarily like saying that. I am not an advocate for private medicine over public medicine. I am an advocate for good medicine. We need to look at clusters of clinics, shared practice, better supports, better IT services, centralising X-rays, blood tests, etc. We can speed all this up with technology. The outdated GP system that many of us are used to and that many of us are exposed to has not served us well. We need more investment in GP services and make greater efforts to keep GPs in public service. There are synergies. It does not necessarily need to be private versus public. Successful synergies work with private and public medicine. We want what works best for people.

I very much welcome this important legislation. In time the Minister should turn his attention to how we can open up and provide greater accessibility to the services for everybody. This is really positive legislation. I have every confidence that the Minister will deliver. The Bill introduces two important measures which are in the programme for Government, relating to the commitment for access. Let us keep the pressure on and see how we can improve GP services for everyone.