Alice-Mary Higgins (Independent) | Oireachtas source

As my colleague said, it is a pity that we cannot debate this Bill in a bit more detail, not because anybody opposes it but because many of us have ideas about medical cards and how they operate and this would have been a great opportunity to address them. Having sat on the Joint Committee on Employment Affairs and Social Protection, I know that people have many concerns and fears around losing their medical card or GP card in respect of different employment. That is a huge area that could be worked on. Senator Conway spoke about the medical card being attached to other essential services on which people depend, and the concerns around that. In the normal course of events, we would have had the opportunity to suggest some additions to the Bill to the Minister. Nonetheless, we support the Bill. It is important and does good work. It is in line with Sláintecare, but as Senator Sherlock noted, it also follows what the World Health Organization tells us about equality of access. It is also in line with the Inter-Parliamentary Union's revolutionary motion last year on universal healthcare as a global commitment from parliaments and the idea of universal access.

Primary care in the general sense is one part of universal healthcare but it cannot simply be about an arrangement with GPs or doctors. It must focus on primary care. We talk about GPs being overwhelmed but one way we can prevent that is by putting in place more services to which GPs are gateways. For example, if we had public diagnostic services, not necessarily always within hospitals but public ones that were accessible at a local level, people who were worried about something for a few months and were still having the symptoms three months later would be able to get a diagnosis earlier. That would relieve pressure on GPs. If we had related services, such as mental health and physiotherapy supports, in place, people would have another point of contact. Such primary care is part of the Sláintecare picture and that is why we are keen for that to move forward.

I share other Senators' concerns about implementing this Bill slowly. We need to implement it immediately because there is so much else that needs to be done. We should not make this service conditional on resources. We know the financial reality of where we are and Ireland can borrow money to do what we need to do to have a healthy population and a new generation that comes up healthy. We know what we need to do and that we can access the resources to do it. We certainly do not want this to be an add-on, or for some nine year olds or eight year olds to get the help they need while some do not.

Others have focused on the six to eight year old age group, but inclusion of the ten to 13 group in the Bill is important and positive. That shift from ten to 13 years old is important because that is when children are about to start secondary school and it is a huge transition point where GP care is important. For example, children with disabilities must plan around and manage their disability or health conditions in a new environment or school and they need to have that GP care. GPs do not just provide acute care, but handle chronic and ongoing conditions and all other parts of primary care.That is why this is really important. It will be a very difficult return to school for many children this year. We have all seen those sad primary school graduation ceremonies before the pupils move on to secondary school. It would be really good if this was ready in September for those children who are facing mental health difficulties and other challenges at this time. It would be brilliant if in September, October or at some point this autumn, that support was put in place for children facing one of the most difficult transitions in their lives to date. I urge the Minister to implement it.

It has been said that some people do not even have geographical access to GPs. That is particularly the case in respect of reproductive healthcare. Many GPs around the country still do not provide the reproductive healthcare services women need. It is really important that is addressed so that women who rely on this card are able to access the services to which they are entitled.

I praise Ireland for something on which it and the UK have shown leadership, which is the provision of videoconferencing with GPs for those who need to access reproductive healthcare and abortion services. That was really useful and positive. I know that other European countries have looked at that when trying to ensure emergency access to GP visits in a time of crisis. I praise Ireland in respect of that video access.

I look forward to more engagement with the Minister and congratulate him warmly on his appointment. I am sure we will talk again.