Health Bill 16 April 2015


Thank you for the opportunity to speak on this Bill.

The provisions of this bill, which makes GP services available free to all people aged 70 and over is most welcome. It is a crucial step in terms of this government’s overall purpose of Universal Health Insurance. Taken in conjunction with the recently announced intention to provide free GP care to Under 6s, we can see that this priority issue for this Government has an impetus and is progressing steadily.

As is always the case in health provision, while these moves are most welcome, much work remains to be done. We still have people who are seriously ill and who cannot access a medical card and this is an issue that this Government will have to continue to work upon.

I know that many individuals and families will breathe a sigh of relief at the passing of this Health Bill, as far too many elderly people in this country are unwilling to visit the doctor even when their health demands that they do so, because of the cost involved. More frequent visits to the doctor should allow some illnesses, infections or diseases to be treated at the most local level, whereas if someone is unable to attend a doctor due to cost, their first encounter with the health service could be at the doors of the Accident and Emergency Department when the matter has become so serious that it can no longer be ignored.

I also welcome the fact that dependants of the person aged over 70 will also qualify for access to free GP services if the person on whom they are dependant has an income of under €700 per week.

Every week at clinics across East Galway I meet elderly men and women who are experiencing extreme difficulty in accessing medical card. I have highlighted many of these cases with the Minister and would ask that the existing regime be examined in terms of how elderly people can access medical cards.

I will give two examples. The first is a man aged in his late 80s. His only income is €4,000 per annum from renting his land. Having reached his late 80s without ever applying for a pension, and being proud of having saved the state so much money in the last 20 years, he was continually refused a medical card because there was no social welfare assessment of his income. There couldn’t be a social welfare assessment because he was adamant that he would not apply for a pension for the remainder of his life. This man was hospitalised a number of times last year, and was living in fear of large hospital bills. He was unwilling to visit the doctor because of the cost involved and so was probably not on the correct medication or was not having it tweaked or changed to reflect his changing circumstances. Thankfully he was granted a medical card in the past month, but this was after 15 months of effort.

Another case is similar, a man suffering from liver disease who hasn’t been to a doctor for about 20 years. He is pension age but cannot access a pension to date because he has never appeared on the radar of any government department previously.
He is also caught in the catch 22 situation of not being able to get a medical card without a social welfare assessment. The matter will probably have to go to a social welfare appeal, but in the meantime valuable time is being lost in treating this man at the most local level in the health service.

As the TDs in this chamber know only too well, the one-size-fits-all does not fit many of the individuals we meet on a daily or weekly basis. Theirs are the one-off cases, where their particular set of circumstances have to be taken into account and while a system such as the centralised medical card system can work well in many instances, for the one-off cases it can be particularly difficult to bring those people over the hurdles they face.

Overall, I very much welcome the provisions of this Bill, it will mean that a great many people who previously could not afford to visit the doctor can now do so. It will alleviate much stress and worry and hopefully early intervention will prevent many serious illnesses and result in better healthcare for our elderly population.

I would also stress that many of these people need the additional step of a medical card and would ask the Minister and his officials to reflect on how best to deal with the more difficult individual cases.