Frances Black (Independent) | Oireachtas source

I welcome this Bill and congratulate the Minister for Health, Deputy Stephen Donnelly, in the strongest possible terms. It is an unalloyed piece of good news and it is important we celebrate these positive developments that everyone in the Chamber can get behind. Hospital charges for public patients undermined the entire philosophy of the public provision of healthcare and the €800 cap is a small comfort for the very ill people burdened by these charges. I am really glad the Government is taking action and that the Minister has taken action to rectify this injustice.I am very glad that the Government and Minister have taken action to rectify this injustice.

However, I will take the opportunity to put on record and discuss some of the other unfair costs that patients and their families have to contend with, which I hope the Minister will consider addressing. The issue of car parking fees has been highlighted by campaigners for many years. The accumulated cost of parking for patients and caretakers who need to attend hospitals regularly can be very difficult for them. This issue has been raised by the Irish Cancer Society and others. These charges are also a major drain on the finances of hospital staff on more modest salaries. The charges may not seem like much to a hospital consultant but cleaners, nurses and healthcare assistants are taking a real financial hit. Unsocial work hours and poor public transportation provision outside Dublin mean that many low- and medium-wage hospital workers are totally dependent on driving to work. This needs to be addressed. There is a commitment to cap these charges in the programme for Government, which is good. I hope that promise will be kept.

Since ending charges for public healthcare is on the agenda, the €100 charge for attending accident and emergency departments should be abolished. Defenders of this charge claim that abolishing it would mean our overly stretched accident and emergency departments would be ever busier but I do not think that is true. When people need care they show up. Nobody wants to go to accident and emergency and people avoid it if they can. I know my friends and family will do anything not to go there. Accident and emergency departments are overcrowded because of long-standing staffing and resourcing issues.

I will also raise an issue relating to the HSE. I am a little shocked by the HSE using collection agencies to pursue patients with outstanding debts. Many of these agencies are disreputable and have received significant legal scrutiny for behaviour that skirts harassment and intimidation in order to recover funds from people who are struggling to pay. Sending debt collectors or heavies after sick, poor people is just not acceptable. It makes a mockery of the values of human dignity and social solidarity that underpin a public health system. The best way to resolve this issue is to make public healthcare truly free at the point of access.

We all know more needs to be done to make care accessible in the community to ease overburdened hospitals. We could do this by expanding the number of places for trainee GPs. It is shocking to think that during a time of such an acute shortage of GPs most junior doctors applying to the training scheme are rejected. We could ease the pressures on GPs by expanding the roles of pharmacists and nurse practitioners. That is being done by some GPs but the role of pharmacists could be a good way to deal with this. These are highly qualified, conscientious professionals who are ready, willing and able to take on greater responsibilities. Empowering allied health professionals could make the delivery of essential everyday healthcare more efficient and accessible.

One example of how this could work is allowing pharmacists to dispense contraceptives without a prescription. The Government's provision of free contraceptives to young women is truly an incredible step forward. Well done to the Minister on that. A feminist republic should defray the extra costs women incur by simply existing. The Minister has done great work in this area. However, for women outside the narrow age range, contraception is a significant expense. The requirement to renew prescriptions with a GP adds further cost and expense. The Irish Pharmacy Union appeared before the Joint Committee on Health recently. It indicated that many of its members would be happy to step up and provide the necessary care surrounding contraceptives. This would be a transformative step forward. It is about trusting women and giving them maximum control over their reproductive health.

I reiterate my congratulations regarding this Bill. It is great we are all supporting something and are not all in battle all the time. I am sure it will provide relief for many people who are enduring difficult periods in their lives. When people are sick, or when they are caring for friends or relatives who are ill, they are at the mercy of the bureaucracies and institutions of healthcare and social protection. As legislators, we need to ensure those systems reflect the humanity of the people they impact. We need to ensure that people feel cared for and supported, not badgered and exploited. Well done to the Minister, his Department and the team he works with. I am very happy and glad to be here to support this Bill.