Liz McManus
Question:31 Ms McManus asked the Minister for Health and Children the percentage of the population on medical cards for each of the past ten years. [31012/01]
Priority Questions (Resumed). - Medical Card Statistics.
The total number of persons and the percentages of the population covered by the medical card scheme for the past ten years and at present are as follows. I will give the information in percentage of the population covered by GMS: 1991, 35.13%; 1992, 35.85%; 1993, 35.77%; 1994, 36.04%; 1995, 35.76%; 1996, 34.59%; 1997, 33.64%; 1998, 31.94%; 1999, 31.42%; 2000, 30.32%; April 2001, 29.87%; October 2001, 31.10%. These are official estimates. The most recent available total medical card coverage figure available to my Department mentions 1,194,000 as the operative figure for end of September, giving the percentage of the population covered at that date as 31.1%.
Would the Minister not agree that there is no more eloquent argument for the case being put by the Opposition that the 200,000 people who were excluded from medical cards should be included immediately? Would the Minister not accept that his decision to exclude these people and refuse to extend the income limits is an absolute disaster? Would the Minister accept that there has been significant decline in percentage terms in the numbers covered by medical cards? Surely he would agree with me that this shows once and for all that the income limits are totally unreasonable in terms of meeting the needs of people on modest incomes who need to be able to access health care? Would he not accept that during his stewardship and that of his Government there has been a steady decline in the number of people being able to avail of medical card cover? It is also clear that costs have gone up and many people who are working today are being put in an impossible position because their income is above the income limit and yet they are becoming an increasingly large portion of our population who cannot afford to take themselves or their families to the doctor as they are not eligible for a medical card.
During the three years of the rainbow Government there was no increase in medical card eligibility.
That is not true.
It has gone down under the Government.
In 1996 it went down to 34% while in 1997, which still reflected the legacy of that Government, it was 33%. Since the Government came to office 300,000 more people are working than in 1997.
But they cannot afford a doctor.
There was no minimum wage under the previous Government. We have introduced and increased it. The extra 300,000 people at work and the economic prosperity of recent years have, of course, reduced the numbers eligible for medical cards. The Government has concentrated on raising the eligibility thresholds for older people, as we promised at the general election. The vast majority suffer a very significant drop in income on retirement. The Opposition has twisted and turned on this issue and made sniping comments.
We were only sniping because we caught the Minister with his backside out the window.
Ultimately, the Opposition voted for it to cover its electoral back. It continues to snipe at a proposal to give medical cards to those over 70 years. This was a good decision with the others affecting older people to significantly improve their lives, especially in terms of access to facilities. We have not excluded anybody. We have also made it clear we are committed to widening eligibility in line with a study undertaken under the PPF to expand medical card eligibility to a further 200,000 people. That commitment is given in the strategy.
The Minister is changing it every day.
Does the Minister now accept that every other list in his Department is going up? The only one coming down is the list of medical cards. The Government is taking them off the poor, the weak and the sick in society. Does that not show it has let them down? Does it not show it has deliberately targeted the weak in society? We listened to the Minister's history lesson earlier. In 1996 the figure was 34.59%; in 1997, 33.64% and now 29%.
We have heard about the additional 200,000 medical cards from the Independent Deputy from County Kerry. Immediately after Question Time I have an appointment with the Minister of State, Deputy Seamus Brennan, to collect my 100,000 for people in County Mayo, because the Minister of State, Deputy Moffatt, has failed. What is happening in relation to medical cards, based on the announcement by Deputy Healy-Rae of an additional 200,000 cards? Where will the Minister get the money to add these 200,000 people to the medical card scheme? Last night I told him where he could find it. He should get rid of the spin-doctors. Does he know anything about the announcement made by Deputy Healy-Rae? Is he not kept informed of what is happening? Perhaps that is what has gone wrong in the Department.
The Deputy asserts we are targeting poor people, but that is not the case. We are not taking cards off anybody. The only reason eligibility thresholds were exceeded in recent years has been the dramatic and extraordinary increase in employment.
What about those on £100 per week?
What about the people he took out of the scheme?
I did not interrupt Deputy Ring once and expect some degree of courtesy in response. The only thing we have done is to give medical cards to those over 70 years. That was what we said we would do at the election. As a result of a study done for the PPF and the health strategy, we have made it clear we want to widen eligibility to cover another 200,000 people.
The discretionary medical card system is also in place. What we issue are not ring-fenced regulations; they are guidelines to health boards and chief executive officers. Those on low incomes who need ongoing medication or are suffering from chronic illness can apply for a discretionary card. When we negotiated with the Irish Medical Organisation last year its complaint was there are too many with medical cards. In return, we made funding available to recognise that a significant part of the system entails issuing discretionary medical cards to those on low incomes in regular need of medication because of chronic conditions.
The budgetary policy of the Government in recent years has been to improve the lot of the less well-off in society. Social welfare payments have increased beyond the rate of inflation.
They are on £85 per week, what more can they want? Surely they do not want a medical card as well.
We introduced the minimum wage and an historic increase in child benefit last year. We have provided far more income through a variety of fiscal and social welfare mechanisms to help those on low incomes. This was considerably more than anything contemplated by the rainbow Government or the parties opposite.
Does the Minister accept that what he has said does not relate to the facts? Does he accept that during the term of office of the Government the gap between rich and poor has widened enormously? The top 10% now have disposable income 13 times that of the lowest 10%. This has happened during the lifetime of the Government.
In hindsight, whatever about the merit of giving medical cards to those over 70 years, does the Minister accept the deal he struck with doctors was bad value for money? The doctors had him over a barrel which meant, in effect, the costs for providing for this change were considerable compared with the good value for money he would have got by extending the income limits for those on low incomes.
In 2002 will the Minister continue to maintain the position whereby a miserable percentage of the population can avail of medical cards? He intends to persist with his refusal to extend medical cards to the 200,000 people currently excluded. They should and could be provided for if the Minister managed to stop believing his own propaganda and started listening to the people.
Equity applies to all areas of the health service. It is neither honest nor proper to suggest that there is only one area to which equity applies. Access to hospital beds is a key issue. My major priority in 2002 is to put more beds into the system to ensure the equity that ordinary people deserve in terms of access to medical facilities in hospitals and elective procedures.
There is a huge equity agenda on disability, which has been neglected for years. In this area we will maintain the momentum, built up by my predecessor, Deputy Cowen, and the Minister for Finance, Deputy McCreevy, which I continued last year and will continue again this year. There have not been too many Private Members' motions on mental health in the past 20 years. There was no hysteria or great protestations because it was never a great electoral issue or vote getter. There is a degree of cynicism about the Opposition.
I have been raising this issue for two years.
Equity is a broader issue.
People are on £100 a week and they cannot get a medical card.