Lorraine Clifford-Lee (Fianna Fail)
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I thank the Minister of State for coming to the House to discuss the very important issue of GP visit cards for six and seven year-olds. As she knows, GP visit cards for those aged under six were introduced a number of years ago and have been a very helpful mechanism for parents to access free GP healthcare for their children.

Children can get very sick very frequently when they are young. Having free GP visits ensures that no family has to work out how sick a child is before it must bring him or her to the doctor and pay a significant fee of €60. This might happen twice or three times in one week. Children can get very sick very rapidly. If a parent is making a judgment call that the child is not sick enough to warrant the spending of an extra €60 from a family budget, the child could get very sick very rapidly. It is a position no family wants to find itself in. No family should have to go without fuel, food, heating or petrol to get to work or school. Those are the decisions families make every day.

In June 2020, legislation extending GP visit cards to all children under 12 was passed. It was announced in budget 2022 last October that free GP visit cards for six and seven year-olds would be introduced this year. This has not yet happened. Given the severe pressures on families and the rising price of electricity, gas, motor fuel and food, I am appealing to the Minister of State to announce today that the commencement of GP visit cards for six and seven year-olds will take place imminently. Parents cannot wait any longer. There is a significant squeeze on families. I know the Minister of State is very aware of what families up and down the country are facing and the real impact of introducing a measure like this on families and health provision for children. It would be a very welcome measure if it was announced today.

I spoke with the Minister for Health this morning about this issue. He understands the urgent need to relieve costs for families. I believe talks with the Irish Medical Organisation, IMO, are ongoing but I think we should prioritise this matter. Things happened overnight during Covid because it was a crisis. The cost of living for families all around the country is also a crisis and needs to be prioritised. I also believe we need to move beyond those aged six and seven quite urgently but given that the commitment regarding six and seven year-olds was in the budget, that needs to happen this year without any further delay. I look forward to hearing the Minister of State's response.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Senator for raising this matter, which I am taking on behalf of the Minister for Health. As the House will know, the Government is committed to increasing access to GP care for more children. Following the provision of GP care without charges for all children under six years of age, the Government plans to expand GP care without charges to all children up to and including the age of 12 on a phased basis, beginning with all children aged six and seven.

Having a healthy childhood can provide the basis for having good health in adult life. Removing cost as a potential barrier for more children will reduce the financial burden on young families in accessing GP care. Improved access to GP services can help build the relationship between the GP and the patient and help increase the likelihood that conditions requiring ongoing care are identified at an earlier stage. The Senator made a valid point. A normal temperature in a child can spike rapidly so it should not be cost-prohibitive for families to access GP care. I reared three children. All three could get sick in one week and I could have three visits very quickly, not to mention 12.

Currently all children aged under six years have automatic eligibility to a GP visit card and therefore have access to GP services without charges. Legislation enacted in 2020 provides for the phased expansion of GP care without fees to all children aged 12 years and under in three phases - children aged six and seven, children aged eight and nine and children aged ten, 11 and 12.

It was previously intended to commence the first phase of the expansion - the provision of GP care without charges to all children aged six and seven - from September 2020. However, it was necessary to reconsider the commencement date due to the emergence of Covid-19 and in recognition of the increased pressure that this expansion could place on GPs. General practice continues to play a vital role in combating the Covid-19 pandemic. There has been an increased demand for GP services during this time and the provision of those services has been made more difficult. In addition, GPs have been called upon to provide additional services, including referring patients for Covid-19 testing, as appropriate, and helping to administer Covid-19 vaccinations, largely to older and more vulnerable persons. It is important to ensure that additional pressures placed on general practice do not limit its capacity to meet the needs of all patients in the community.

Notwithstanding that, I am pleased to say that budget 2022 has provided for the expansion this year of GP care without charges to children aged six and seven. The Department of Health and the HSE are now working on the roll-out of the expansion. This will, of course, require consultations with the IMO to agree the contractual terms. When commenced, it is estimated that this first phase of the expansion will provide GP care without charges for up to approximately 80,000 additional children aged six and seven.

More generally, the Government has taken numerous steps to increase capacity in general practice to allow for the expanding of GP care without charges over time and on a phased basis, as proposed by Sláintecare. In particular, expenditure on general practice has been significantly increased under the 2019 GP agreement and measures have been introduced to make general practice more sustainable. It is also worth noting that the number of entrants to GP training increased from 120 in 2009 to 233 in 2021, with further increases planned. That is the answer the Minister gave to me. I am conscious the Senator had conversations with him since I received my script and I hope he had positive news for her.

Lorraine Clifford-Lee (Fianna Fail)
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I know the Minister of State would be very much aware of the pressures on families and how important free GP visits have been for families to date. I am disappointed that no date has been given for this expansion. It is very welcome that it is acknowledged that it needs to happen urgently. I know negotiations can be sensitive and I am also aware of the pressures faced by our GPs over the past 12 months but these children are patients of those practices and will be accessing the service in any event. All we are doing is providing relief for families. It is not as if families will suddenly start flooding into GP practices if they get the card. They are deciding between putting food on the table or bringing a sick child to the GP. When they do not access primary care, they end up in accident and emergency, which costs the State even more, so we really need to prioritise this measure.I will be back in contact with the Minister about it. I want to get a date for this. The families are waiting for this and need it urgently. I have been in contact with many families about the matter. They have been asking about it specifically. They are very conscious of this. There are children who timed out when they turned six and are now in a lacuna. Those children are eight years old now and have been without free GP visits. This matter is very important, and I will be back in contact in respect of it. This is a very practical measure that can relieve the rising costs for families.

I thank the Minister of State for attending. I hope she will have a word with the Minister about this matter.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Senator. She is being very rational in the context of her proposals. If we do not do that early intervention piece, it has a knock-on effect whereby it is more costly in the long run to our health system. I urge the Department of Health and those with whom it is having consultations , be it the HSE or GP practices, to talk about the same cohort of people who need that care. Now is a timely opportunity, especially when all the other talks are taking place in the context of how we can support families. Now is the time to have that conversation in the round and to look at GP care for children aged six and seven.