Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I am very pleased to introduce the Health (Amendment Bill) 2023 to the Seanad. This Bill means that adults will, for the first time in our Republic's history, have free access to inpatient hospital care. As colleagues will be aware, people in Ireland are currently charged €80 per night to use a public hospital, up to a total of €800 in one year, which would be a very large bill. Patients and their families have faced this bill when they are very sick, their ability to work might be compromised and their household income can be very low. Last year, we abolished this charge for children under the age of 16. Now this Bill does the same for everybody else.

The measure in this Bill is important in its own right. It is also a clear symbol of our country's path towards universal healthcare and a high-quality, affordable public healthcare system that is available to people when they need it. Over the past three years, we have been radically cutting the costs of healthcare for patients and families. In 2021, we reduced prescription charges, increased medical access for those aged over 70 and extended to two years medical cards for those with a terminal diagnosis. In 2020, we reduced the threshold for the drug payment scheme. Last year, we abolished inpatient hospital charges for children, introduced free contraception for women aged from 17 to 25 and reduced the maximum amount a family pays for medicines to €80.Already this year, we have expanded the free contraception scheme to women aged 26. The Bill abolishes inpatient hospital charges for adults. In the coming months, we will provide GP cards to nearly half a million more men, women and children. This means that for the first time since the foundation of the State, well over half the people in our country will have either a medical card or a GP card. Later this year, we will expand the free contraception scheme to those aged up to 30 and, for the first time, we will introduce State-funded IVF treatment.

Combined, these cuts in costs for patients amount to a fundamental shift towards our collective vision of universal healthcare provision in this country. The reductions we have already introduced are making a difference to patients and families. We are determined to keep that progress going. The cuts in costs for patients are being introduced at the same time as the provision of new services for patients, including IVF treatment and other women’s healthcare measures such as specialist services for the treatment of endometriosis, perinatal mental health, menopause and other areas. This is being done in tandem with better access to new medicines. I was delighted to share the news last week that Kaftrio has been made available for the 35 children who were last year excluded by the company that manufactures it.

I acknowledge the significant work done by officials in my Department in drawing up this Bill and, especially, the work done by patient advocate groups right across the country. Its provision on patient charges is a measure that has been advocated for by the Irish Cancer Society for years. The society has pointed out that cancer patients, and their families, are already dealing with the extraordinary stress of their disease and its treatment, on top of which they are faced with significant additional bills. I acknowledge the Irish Cancer Society's advocacy over many years.

I will now provide a brief explanation of the sections of this gloriously short Bill. I was told in the Dáil last week that it is the shortest Bill that has been introduced in this Government's term. Section 1 repeals section 53C of the Health Act 1970, which provides that charges shall be made for acute inpatient services provided by or on behalf of the HSE. Section 1 also revokes the Health (Acute In-Patient Charges) Regulations 2021, SI 213 of 2021. These regulations provide the legislative basis for the persons liable for the acute public inpatient charge and specify that the maximum number of days for which the daily charge may be imposed over a period of 12 consecutive months shall be ten days. This amounts to a maximum charge of €800.

Section 2 contains standard provisions setting out the Short Title and citation and providing that the Bill shall be subject to a commencement order. The key effect of these amendments is to remove the acute public inpatient charge of €80 per day up to a maximum of €800 in 12 months for people accessing care as public patients in public hospitals.

I take this opportunity to provide some detail on other eligibility measures we are introducing this year, some of which I have referenced. Eligibility for GP cards will be extended to people who earn up to the median household income, with this provision to be phased in from April. This will remove the cost of accessing GP care from those for whom cost is most likely to prevent access, thereby helping to reduce the cost of living for young adults and young families in particular. More than 400,000 additional people are expected to become eligible based on income. My Department is working with the HSE and the Irish Medical Organisation, IMO, to expand this provision to children aged six and seven, which will amount to another approximately 70,000 people.

We are aware that these measures will increase demand for the services of our already busy GPs. Therefore, a significant funding package is being made available to GPs to support general practice to increase its capacity. The two are being done in tandem. The additional funding this year builds on the significant funding that has been put in place over the past few years. The 2019 agreement saw funding for GPs for General Medical Services, GMS, patients increase by 40%, as well as the provision of increased supports for rural practices and practices in disadvantaged urban areas and improved leave-taking arrangements. There is more to be done and more supports needed for general practice but we are moving rapidly in the right direction.

We launched the free contraception scheme, initially open to women resident in Ireland aged 17 to 25, in September last year. This was an historic initiative providing, for the first time, for free access to prescription contraception and directly supporting women and their partners in their sexual and reproductive health. The scheme will be expanded further later this year to women between the ages of 16 and 30, with the lower age limit subject to various legal advices that are needed.

Colleagues will be aware of a commitment in the programme for Government to introduce publicly funded care for fertility treatment. Phase 1 has involved the establishment of regional fertility hubs that can provide appropriate treatment to a significant portion of people presenting with fertility issues. Phase 2 will see the introduction of tertiary fertility services, including IVF, with State funding for IVF being rolled out later this year.

Since my appointment, we have also provided dedicated funding of almost €100 million for new medicines. The full-year amount is significantly more than that. This new funding has facilitated the approval of 112 new medicines or new uses for existing medicines. I am happy to say that 34 of those 112 approvals, or nearly one in three, have been in respect of orphan drugs or treatments for rare diseases. This is something many Senators have campaigned for, advocated and regularly sought. I am committed to ensuring greater transparency around and greater speed of access to new medicines for patients in Ireland.

The programme for Government sets out a clear path for expanding and achieving universal healthcare that is high-quality, affordable and accessible. We have delivered and are continuing to deliver on that commitment. Colleagues will be aware that last year saw waiting lists fall for the first time since 2015. It was pointed out to me earlier today that Ireland is one of only a few countries internationally that managed to see waiting lists fall last year following the Covid period, with all the additional burden that brought. In fact, when we look at the number of patients waiting longer than the agreed Sláintecare targets versus the Covid peak to the end of last year, we see that 150,000 fewer men, women and children were waiting longer than those targets.

There is a long way to go but this is a good start. The Bill before the House today is one additional measure aimed at reducing costs for patients, specifically the €80 a day inpatient charge. It means the only charges public hospitals will now apply are for emergency department care or minor injury unit care. Once the Bill is passed and implemented, which we hope will happen in the coming weeks, other charges, including for diagnostic and inpatient services, will be a thing of the past.