Vol. 539 No. 3
2 Ms McManus asked the Minister for Health and Children if he will outline the arrangements he has made to resolve the dispute with the Irish Medical Organisation regarding the provision of medical cards for the over-70s; the method of payment that is planned in respect of these patients; the guarantees he can give to patients over 70 who qualify for the scheme that it will begin on schedule; and if he will make a statement on the matter. [19194/01]
The extension of the medical card scheme to give automatic eligibility to persons aged 70 and over was announced in the budget and it is a well-established practice that such announcements do not involve prior consultation with parties which, in other circumstances, would be consulted.
Negotiations have taken place with the Irish Medical Organisation with a view to resolving this issue and, while some progress was made, these negotiations concluded early this morning without achieving a resolution.
While regrettable, I wish to make it clear that the Government is prepared, within reasonable limits, to concede significant increases in capitation payments to GPs in respect of persons aged 70 and over who avail of the new scheme, and efforts will continue to be made to resolve the issue. However, the Government regards the current demands of the Irish Medical Organisation concerning their participation in the new scheme as excessive in the context of the additional work involved, but efforts will continue to resolve the issue. It would not be appropriate to comment further at this stage on the detail of the negotiations.
I intend to sign the commencement order that will give effect to the Government's decision, subsequently given legislative effect by the Oireachtas. I feel obliged to do this because of the other benefits that accrue to holders of a medical card. Contingency arrangements have been made with health boards to issue medical cards. I hope it will be possible to reach an early resolution with the Irish Medical Organisation on outstanding matters.
Does the Minister agree that the Government has a disastrous record regarding this matter, which was announced in the budget without any preparation? It did not declare until very late that legislative change would be required. It had to do a U-turn in that regard.
More importantly, ever since this measure was announced in the budget, the Minister for Health and Children has been on a collision course with doctors. Within days of the measure supposedly being ready for implementation he is unable to tell the House that it will be provided. He will agree that is extremely disappointing and disturbing for those patients over 70 years who were expecting the Government to honour its word.
Does the Minister not think it revealing that he has travelled the country preaching that partnership is the way forward for the health service, given that, in this instance, there was a total absence of partnership? The measure was announced without any consultation or regard for its implications. He is now reaping a whirlwind of discontent among doctors because of his sledgehammer approach. Given that he is determined to sign the order, will the Minister comment on the fact that the IMO is talking about rolling industrial action? Surely he sees that this is a serious matter, especially given that other issues that have not been addressed are now being brought into negotiations. The Minister is presenting a red rag to a bull. Rather than ensuring this measure was dealt with early on, he has engaged in brinkmanship. Such methods are not good for the health service, especially the relationship between patients and doctors. Does the Minster agree that this ill thought out and opportunistic measure, brought forward to try to earn brownie points for Fianna Fáil, has blown up in his face? It has led to great anxiety and worry among patients who expected they would have the security of a medical card as a matter of course on 1 July.
I must express my surprise at the Deputy's consistently strong defence of the profession involved in this matter. The line of attack from the Labour Party has been on the side of the professionals, as opposed to older people.
That is not true. We are on the side of patients.
I did not interrupt the Deputy when she made a series of points via a question. Budgets are made by Governments elected by the people, they are not negotiated. There was no negotiation before decisions were made in the past, such as extending free travel to over 65s or introducing free secondary education. Governments elected by the people are entitled to make fundamental decisions on eligibility. Irrespective of who is in power, I defend the right of Governments to make decisions on which no organisation should have a veto. This matter is of interest to all Members, some of whom have more expensive plans regarding the extension of the medical card and access to GP cover. As the matters under negotiation will have significant implications for the proposals of other parties, Members should take a reflective stance.
Negotiations are a two-way process and only last April a significant deal in relation to practice nurses and secretaries, asylum seekers, discretionary medical cards and equipment grants was concluded with the IMO, amounting to about £10 million. There was another major agreement last year concerning significantly increased rates of immunisation. It would be wrong to say that the Government has been adversarial with the IMO, as its track record shows it has been particularly generous. While discussions are ongoing, I am hopeful as significant offers have been made.
