Health (Alteration of Criteria for Eligibility) Bill 2013 – 21st March 2013

 I am glad to have the opportunity to speak to this important legislation. It is particularly distressing for any Minister to have to introduce cuts in health services for older people, and any cut is always felt by this vulnerable group, which is more prone to illness. That is understandable. The Minister and his Minister of State, Deputy White, are clearly very conscious of that. Nevertheless, it should not go unnoticed that the number of medical card holders expected at the end of this year will be 1.9 million, as opposed to the current number of 1.8 million.

I have listened with interest to the heart-wrenching allegations of hardship from the Opposition all evening but I do not understand the comments. This is a corrective measure within the system to try to make the budget meet requirements that will be greater than they were in the year gone by: it is about being able to pay for services until the end of the year. The expected number of GP visit cards being used at the end of 2013 will be 265,000, as opposed to the current figure of 130,000.

I am not sure where the outrageous indignation that has been expressed by some parts of the Opposition in the past hour or so has come from. We are all aware of how difficult it is for people to function now. This Minister of State and others must be watching with incredulity nevertheless. In the past two years, the total cost of motions proposed in this House by the Opposition would have had a total cost of between €12 billion and €15 billion. That would be on top of the current budget deficit of between €12 billion and €15 billion. The grandiose proposals, which appeal to the hearts and minds of the people, would only double our current budget deficit. Nevertheless, it was never mentioned in the House that those actions would create more hardship for the people, including those who currently have medical cards but who would lose them if we continued on that way.

There was a time when the Opposition would be asked what to do but that seems to have gone by the wayside and nobody seems to ask that question now. Those opposite only seek more spending, and not one person from the Opposition has put forward a single proposal to raise revenue. They are only appealing to the public and arguing that everything is all right because we can get more money from banks or another group of individuals. They want to pour more money on so-called troubled waters. It is about time to be honest with the people of this country and we must tell them how it is. When those opposite were in power there was a promise to extend medical cards to everybody over 70. That promise was made just before an election, and such statements served their purpose.

As I said previously, it is very regrettable that alterations have to be made to the eligibility criteria for medical cards for people over 70. However, the other side of that coin is the fact that more people will have medical cards and GP-visit cards at the end of this year than currently hold them because more people are coming into the marketplace all of the time and provision must be made for them.

I have been consistent in recent years in trying to ensure that the Department of Health monitors its expenditure on a monthly, if not weekly, basis to try to ensure that major cuts do not have to be made at the end of the year because spending was not monitored properly. The Minister and Minister of State are correct in doing that, even though this decision is difficult.

I am not trying to make a political point when I say that I am saddened that former Government Deputies who are now in opposition accept no responsibility whatsoever for the situation now affecting the nation. Deputy Finian McGrath may laugh at that and think it is funny.

The people in this country must recognise that there are no easy options. The country continues to be in a precarious situation. At the best of times, it was a difficult situation while at the worst of times, we could have fallen over the cliff. We are very lucky to have political parties in this country that were prepared to take responsibility for running the country at this difficult time. On taking office, this Government inherited all of the bills, both private and public but both parties in Government accepted the challenge. In other European countries, parties offering for Government in a similar climate have failed and continue to fail.

As I pointed out last night, there has not been a single indication from anybody on the other side of this House that he or she intends to do anything other than spend the public’s money. The Opposition wants to spend money that the public will eventually be accountable for, in terms of repayments. It wants to spend money that does not exist even though this country is €1.2 billion short of meeting its commitments every month. That is a stark and startling situation and in that context, I hope that there will be a recognition by the Opposition that the situation in which we find ourselves must be remedied. It cannot be remedied by people who were in control at the time and who now wish to run away from reality. Simply because certain Deputies happen to be in County Meath engaged in a by-election campaign does not relieve them in any way of responsibility for what they entered into when they were in control.

Sadly, people’s feelings are being manipulated in a cynical fashion at the present time. People are being treated as if they are children and that is not fair. It is not fair to the people, to political parties and to Independent Deputies. Everyone must recognise that we are in a difficult and tight spot. This Government does not take any pleasure in doing what has to be done. It grieves Ministers and the Government as a whole greatly to have to do some of the things we are doing.

There is no point in trying to say that European institutions did this to us because they did not. We did it to ourselves, individually and collectively. People can seek someone to blame but we must all take some responsibility. To take that point to its logical conclusion, why not challenge and charge people for malfeasance under various Acts? Why not bring people to court, charge them and see what happens then? However, as we know from experience, very few people want to accept responsibility for their activities in the past. There have been many investigations in this House, the DIRT inquiry being a prime example, but very few people have been willing to accept responsibility for their actions in the past. That is the way it has been and continues to be.

It is with great regret that the Government finds it necessary to review the entitlement to a medical card for those over 70, even though the decision to grant medical cards to such people was made in the run-up to a general election, in order to buy the votes of older people. That decision was made with the approval of many Deputies who are now on the other side of the House. That is the reality and unfortunately, avoiding reality is something we have been particularly good at in recent years. This Government recognises that the decision now being taken will create difficulties. It will create difficulties for Ministers, backbenchers and members of the public. It will create difficulties for families, for those at work and those unemployed, as well as those who are retired.

Sadly, there are very few options available to us and none is easy. When people pretend to insist that there are easier options available, they are wrong and they continue to damage public confidence in the institutions of the State.

I have been a couple of years in this House and I have seen it all before. History has indicated that succeeding generations seldom learn from the mistakes of their predecessors. We have only to consider what happened in Europe in the 1920s and subsequently to see this, and the same arguments are taking place now that took place then. These are arguments about who is to blame and how we can get even. This usually ends with people getting even only with themselves, which is tragic.

It goes without saying that Ministers are doing everything possible to alleviate the burden on the people affected by this and other measures. This comes as no surprise and many of us anticipated this problem two, three, four or five years ago. Many of us predicted everything that happened. We must ask the question of whether we can afford a repetition of the kind of scene we have or have had for the past number of years, with the people led to the top of the hill and shown the vista before them as the promised land. Suddenly, hopes were dashed and people found themselves between a rock and a hard place. It is truly appalling.

This is not a political point but rather a lesson for everybody who enters this House from now on. If there ever was a lesson to be learned, it should come from the indiscretions of the past 15 years, when it was quite clear the economy was going well and could fend for itself. Greed took over, everything was thrown by the wayside and the idea was for everybody to have a party. Unfortunately, we are now paying for that in spades.

I hope people will understand this measure and if they do not, there will be a worse problem that must be dealt with in a different way at a different time. To those who say we do not know what we are talking about, that idea cuts both ways.