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Health (General Practitioner Service) Bill 2018 [Seanad]: Second and Subsequent Stages (Continued)

Wednesday, 11 July 2018

Dáil Éireann Debate
Vol. 971 No. 6

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(Speaker Continuing)

[Deputy Finian McGrath: Information on Finian McGrath Zoom on Finian McGrath] General practitioners, GPs, provide support and assistance to carers in managing and maintaining their health and well-being. We are all too aware of the various health impacts suffered by carers, including the physical strain on their bodies and the associated mental health impacts. General practitioners also play a vital role in assisting the carer to care. General practitioners are valuable resources who have excellent knowledge of the supports and services available to carers in a locality. This is why we want to extend access to GP care for carers. While many carers might in theory have access to GP care, that care may not always be accessible due to the financial barriers carers may face.

Carers often have to reduce their hours of work or even give up work entirely but, although this is often done unselfishly, it does place a financial burden on their shoulders. Removal of this barrier and the introduction of free GP care to an additional 14,000 carers will therefore prove to be a significant benefit. Some 14,000 carers will benefit from this legislation. Carers' financial worries or anxieties regarding their ability to pay for this service will be eliminated. Instead, they will have access to high-quality GP care centred on their needs, which will ensure their own health does not deteriorate, particularly as we know that their health tends to do so gradually as their hours of caring increase over time. The HSE has indicated that carers will be able to apply for a GP visit card from 1 September 2018. Applicants will be facilitated to make either a paper application or an online application.

This measure is just one of a series of measures introduced in recent times to aid carers. As Members are aware, there were successive €5 increases in social welfare payments for carers in budgets 2017 and 2018 and an extension from six to 12 weeks for the continuation of these payments after the death of a cared-for person or that person's entry into residential care. This has gone some way towards easing the financial burden on the shoulders of carers. Last December, additional investment of €10 million in respite care services was announced. This will enhance the provision of respite care to people with disabilities, enabling more carers to take a break from the daily caring routine. It will provide them with much-needed time to maintain their own health and well-being. These actions reflect the commitment in A Programme for a Partnership Government to have a stronger voice for carers. We have listened to carers and have taken positive actions to address their needs.

I will now outline in general terms the main provisions of the Bill. Section 1 provides the relevant definitions to the Health Act 1970 and the Health (General Practitioner Service) Act 2014.

Section 2 provides for an amendment to section 47 of the Health Act 1970 in order that the HSE's appeals process can be extended to encompass this service.

Section 3 provides for an amendment to section 47A of the Health Act 1970 in order that the HSE's current "ordinarily resident" framework is extended to cover the provision of a general practitioner medical and surgical service for persons in receipt of carer's benefit or carer's allowance.

Section 4 provides for a new section 58D in the Health Act 1970 to provide in law for this new service. Section 4 of the Bill contains the text of the new section 58D, which has five subsections. Subsection 58D(1) provides that the HSE shall make available without charge a general practitioner medical and surgical service for persons in receipt of carer's benefit or full or half-rate carer's allowance. Subsection 58D(2) requires that persons in receipt of the carer's benefit or full or half-rate carer's allowance, furnish any necessary documentation the HSE requires from applicants to establish if they are, or continue to be, eligible for this new service. Subsection 58D(3) enables the HSE to deem persons in receipt of carer's benefit or full or half-rate carer's allowance who do not furnish the necessary information required as not eligible for the service provided under section 58D. Subsection 58D(4) provides that the HSE, insofar as it is practicable, provides a choice of GP for the services provided under section 58D. Subsection 58D(5) provides that "Act of 2005" means the Social Welfare Consolidation Act 2005.

Section 5 provides for the Long Title and Short Title of the Act and relevant commencement provisions.

All of us will be touched by caring at some point in our lives, whether we take on a caring role or need care ourselves. For me, this Bill is about looking out for people who spend their time looking out for others. Caring for those in need provides a major contribution towards health and social care in Ireland. Our Government recognises the major contribution carers make to the welfare of others. We aim to strive for a society that respects, values and supports carers. The needs of carers are being considered across Government and I hope we will receive cross-party support on this important legislation. I am personally very pleased to introduce this legislation. I would like to take this opportunity to stress the importance of enacting it before the summer recess in order that this service can be in place for carers in September.

I am sharing time with Deputy Michael Moynihan and Deputy Brassil.

Fianna Fáil supports the extension of GP cards to all carers and will be supporting this Bill. The Bill proposes a modest extension of the GP card to an additional 14,000 carers and this will be very welcome to every single one of them. It is very much deserved. It is estimated that carers provide approximately 7 million care hours every week, saving the State approximately €10 billion in unpaid care every year.

We are all aware of the sacrifices families make while caring for their loved ones. This Bill goes some way towards recognising those sacrifices and supporting the individuals. We need to go further than this Bill, however. We need to address the 6,500 older people waiting on home care and home help at present. That represents an increase of 19% just since last December. In the west and north west, the issue is particularly bad, with targets missed by more than 100,000 care hours just in January, February and March of this year. We must increase home care supports if we are to meet the demand.

We need to ensure that all carers receive a GP card. Family Carers Ireland has pointed out that even with tonight's measure, there are still carers who can be identified by the State as carers who will not be covered. I have tabled an amendment to address this. We will talk about it on Committee Stage.

Those in receipt of the carer's support grant, formerly known as the respite care grant, and who are not in receipt of the other payments will not receive the GP card based on this Bill. The good news is that the money should be in place. It has already been set aside to allow the extension to those in receipt of the respite care grant or carer's support grant. As the Minister of State knows, the Minister, Deputy Harris, stated some time ago when he initially started talking about this that €11 million would be set aside. It turns out that when the Department calculated its numbers, significantly less than €11 million was required. I understand that approximately €2.5 million will be required on foot of this Bill for those in receipt of the carer's allowance and less than half a million euro will be required to cover those in receipt of carer's benefit. The information we have is that the provisions in this Bill will cost approximately €3 million. Critically, we were told that approximately €11 million had been set aside when the idea was initially floated. The obvious question is whether it was the initial intention, when the idea was floated, that those in receipt of the carer's support grant would already be covered. The Government will be required to run the numbers in the Departments of Health and Public Expenditure and Reform. I have taken a look at some preliminary figures. It seems extending the GP card to those on the carer's allowance, which we support, to those in receipt of the carer's benefit, which we support, and to those in receipt of the respite care grant or carer's support grant who are not already in receipt of one of the other two grants could be done and that the cost still would be significantly lower than €11 million. We will be supporting this Bill. It is a move in the right direction. It recognises the important work of carers. It will come as very welcome help for the 14,000 carers. I would like to talk to the Minister of State about extending coverage to the other group also.

Deputy Michael Moynihan: Information on Michael Moynihan Zoom on Michael Moynihan Like my colleague, I welcome this Bill. There are three issues I want to raise. The Minister of State referred in his opening remarks to the additional investment of €10 million for respite care services. There is a chronic crisis in respite care. We were told about the extra money coming in. I have worked closely with families to try to get respite for carers, particularly those caring for people with intellectual disabilities.


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