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Thirty-ninth Amendment of the Constitution (Right to Health) Bill 2019: Second Stage [Private Members] (Continued)

Tuesday, 26 November 2019

Dáil Éireann Debate
Vol. 990 No. 1

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Deputy Maureen O'Sullivan: Information on Maureen O'Sullivan Zoom on Maureen O'Sullivan Cuirim fáilte roimh an díospóireacht anocht. It is very opportune coming after the many debates and discussions we have had on health recently, including Deputy Pringle's motion last Tuesday on personal assistance.

Today we have so much knowledge and awareness and we know what to do, why we should be doing it and how to do it, but the problem is implementation. We have theories, visions and principles that sound lovely. Deputy Harty's comprehensive briefing outlined today that the Department of Health's strategic objectives allude to supporting people to lead healthy and independent lives. Sláintecare sounds so lovely, as do "universal single-tiered health and social care system" and "equal access to services". There is a wonderful phrase, "based on need and not ability to pay". When we move to the questions of accountability, goals and timeframes in which to achieve goals, however, there is a totally different scenario. Every Deputy knows the reality of this. We are all being contacted about it. My most recent case in this regard was raised by a married couple in my constituency. The man has been diagnosed with a rare disease. The couple's problem is the lack of clear information from the HSE, the consultant and the registrars. The word the couple used about the attitude towards them was "patronising". The couple does not want to be bumped up the list; they just want clear information on their current situation. That is not taking from the excellent care patients get in the system. There are examples of best practice but they are not universal.

We live in a democracy. Equality is supposed to be the cornerstone but citizens and other residents are not treated equally. This is what Deputy Harty's Bill is trying to address. The inequality begins long before the person gets to the doctor, hospital or clinic. We have the statistics and reports that show that one's socio-economic background has a major impact on one's health and life expectancy. This is very evident in parts of my constituency. The Bill is trying to address that by focusing on equal rights, affordable access and the common good. This is connected to the point on healthcare and healthy conditions. The reality is that there are so many living in unhealthy conditions, overcrowding, dampness and unhygienic conditions, not to mention the particular health needs of certain groups, such as Travellers in certain types of accommodation and rough sleepers.

An example I know so well concerns people with an addiction who want to take the first step towards recovery. If they have private health insurance, they get quicker access to residential treatment. Without it, it is a different matter. We are aware that the projects in the inner city are doing so well. The Minister for Health, Deputy Harris, was in SAOL recently. Soilse, Crinan and Chrysalis are all on reduced budgets that have not been restored. The Recovery Academy has a wonderful event every year on Merrion Square. It is so uplifting and positive. Once one person gets into recovery, the knock-on effect on the family and community is unbelievable. There is a payback for others who are trying to get into recovery.

Sláintecare and the strategy require something like Deputy Harty is proposing in order to turn the visions and objectives into reality. It is incredulous that we are having this discussion in a country that is relatively wealthy, that has a thriving economy and that has a relatively small population. It is unbelievable that we have not got it right for everyone. Constitutionally enshrined rights to health and to realise the vision are required.

The Bill has been crafted carefully to prevent punitive legal proceedings. Transparency is central. The onus is on the State to explain its inactivity. It is really about being proactive, not reactive.

Deputy Thomas Pringle: Information on Thomas Pringle Zoom on Thomas Pringle I fully support the Bill. It is worthwhile. Rights to health, to education, to life and to live life to the full are what all citizens should be demanding. The State and Government should be ensuring everybody has these rights. I proposed economic, social and cultural rights twice in the Dáil. My Bill was to enshrine rights in the Constitution. Dr. Harty's Bill is along the same lines. I welcome that. It could be expanded to include all economic, social and cultural rights but since the Government will probably not accept it, my point will not make any difference. It is very encouraging, however, that many members of the Opposition are putting forward Bills to have rights enshrined in the Constitution. There is no doubt that citizens need them. Deputy Maureen O'Sullivan highlighted in her contribution the need to have these rights protected across the board.

Fianna Fáil and Fine Gael will not enshrine these rights in the Constitution because they want to control budgets and how people access services. They want to make it a political gift to give rights to people and extend services to them. It should be within the gift of this Parliament to give everybody what I propose.

In their day-to-day work, Deputies note that even the Head of State pushes for citizens to have health insurance. I believe this is a crime and that the €1.5 billion spent on health insurance could be put into health services to create health services for everybody. I do not believe I should use my tax to supplement other people's health insurance. My tax should be supplementing a health service that everybody can rely on. Nobody tries to break down the detail for people. How many people feel threatened or under pressure to have health insurance in this State? They do not realise the reality. In the past year, a number of people came into my constituency office complaining about health insurance, saying that if they wanted access to treatment, they would have to have health insurance. People do not have to have health insurance. If one has a medical card, the maximum cost will be the cost of seven or eight days of hospital care. All one's treatment will be free. That message has to go out very strongly to all citizens. The contention of politicians and health insurance companies that people must have health insurance is basically a scam. People have healthcare and entitlements, and they should be allowed to proceed on that basis.

In contributions in the Dáil today, Deputies referred to information provided by the Irish Cancer Society indicating people cannot obtain medical cards because they believe their income is too high. The medical card is based on income, not illness. That is reality. No matter how ill people are, they have to go through the whole process of showing their income is over the limit. Only then is the illness considered. In a normal society in which people are treated fairly, medical cards would be given on the basis of illness. This should happen.

Deputy Seamus Healy: Information on Seamus Healy Zoom on Seamus Healy I am sharing my time with Deputies Eamon Ryan and Shortall.

I welcome the opportunity to speak on this Bill. I confirm my support for it. It is particularly important when we think of its background, including the chaos in our health services, the overcrowding, long waiting lists, the lack of mental health services, dysfunctional disability services and, of course, the two-tier health system in which ability to pay trump's access to medical services based on medical need. Also part of the background is the unanimous agreement on the Sláintecare report.

The Bill, as Deputy Pringle implied, is similar to a Bill he and I introduced in 2014, namely, the Thirty-fourth Amendment of the Constitution (Economic, Social and Cultural Rights) Bill 2014. I welcome Deputy Harty's Bill as it is necessary. It is well-intentioned and I will certainly be voting for it but I do not believe it goes far enough. As Deputy Pringle said, economic, social and cultural rights should be enshrined in Bunreacht na hÉireann. I refer, in particular, to the rights to work, to have just and favourable conditions at work, to form trade unions, to join a trade union of choice, to social security, to the widest possible protection and assistance for families, to an adequate standard of living, to adequate food, clothing and housing, to the highest attainable standards of physical and mental health, to education, and to take part in cultural life.

It is almost 30 years since Ireland ratified the International Covenant on Economic, Social and Cultural rights, in 1989, yet these rights have still not been enshrined in our Constitution. In fact, since 1989 the UN committee responsible for implementation has written to the Irish Government on a number of occasions asking that its measures be implemented. They should be implemented urgently.

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