GP card move a mad move. We need universal healthcare system

What are you doing? What the hell are you doing?

You’re giving a GP cards to 240,000 children under six whether they’re rich or poor, sick or healthy. And you’re taking their full medical card off perhaps one in 10 over-70s.

And you’re going after those who are already sick and on medical cards by increasing the prescription charge by a euro to €2.50, a five-fold increase since the charge was introduced three years ago.

What are you doing, Mr Government?

You should know by now that ill-costed universal hand-outs come back to haunt politicians. You sat sniggering on the Opposition benches while the last government attempted to wriggle out of the financial strait-jacket which Fianna Fáil had rigged for itself in 2001 by announcing a medical card for every 70-plus in the audience.

They hadn’t costed it properly. They hadn’t negotiated it with the doctors. But when the Fianna Fáil-Green government suddenly ran out of cash in 2008 and Brian Lenihan introduced an income threshold on the over-70s medical card in an effort to protect the genuinely poor and the genuinely sick, he was spat upon from all sides.

Labour’s spokesperson on health at the time, Jan O’Sullivan, said, “The re-introduction of a means test for medical cards for the over-70s has to go down as one of the most cynical political stunts we have seen in quite some time.” When the embattled Government revised the income threshold upwards, Eamon Gilmore still wasn’t happy, complaining that he didn’t trust the Government not to revise it downwards again.

You’ve not only kept the threshold, you’ve lowered it yourselves, Mr Government. You’d think you’d understand you’re storing up trouble for yourselves — and us — by introducing the GP card to the under-sixes without proper costings, full negotiations with the doctors themselves, and in the context of a health budget which is heading for an over-run and must be reduced next year by an estimated €666m.

You’ve been wiser than Fianna Fáil in not choosing the sickest and fastest growing segment of the population to target with your largesse. Wherein lies the cynicism of this provision. You’re reducing the income ceiling for a full medical card for the over-70s by €100 a week. You’re taking away the safety net of a full medical card from a recently employed person. You’re attempting to make savings of €113m by cancelling thousands of medical cards whose holders are not entitled to them, although this is based on calculations of scarcely credible roughness, such as the fact that 21% of a group surveyed didn’t return their questionnaires. And you’re asking the sick and needy to fork out an extra euro per drug at the pharmacy, up to a monthly cap of €25.

Instead, you’re giving a full medical card to thousands of healthy, wealthy babies and children under six, whether they need it or not.

They should not have much use for it. The children of those already in receipt of a full medical card are already covered. Otherwise, most babies and small children are healthy and most visits to doctors could be avoided if we had anything approaching the UK’s health visitors or Sure Start children’s clinics.

My eldest kid had been to the doctor about three times before he was six, but then he don’t get the benefit of early exposure to bugs. And he only had four months breast-feeding, while the other three were breast-fed for over a year and, apart from visits for vaccinations. they had never been to the doctor by the time they were six.

If the Government were really serious about improving the health of babies and small children they would start with a massive initiative to encourage breast-feeding in this budget. This is how New Labour kicked off Sure Start in the UK in 1998. There were even 24-hour breast-feeding helplines aimed at transforming health outcomes for the most disadvantaged babies.

Gastroenteritis is the cause of 50% of GP visits by under-sixes in Australia, but breast-fed babies are four times less likely to suffer it. The other common ailments which send babies and young children to the doctor, severe colds and ear and throat infections, are 63% less likely in babies breast-fed for six months.

There are hardly any such babies in Ireland. We have the lowest breast-feeding rate in the developed world and have been censured for this by the UN. The GP card will only tackle the symptoms of these common baby illnesses, often with anti-biotics, but there is no strategy to prevent them in the first place.

Even if we had universal breast-feeding there would still be some very sick babies and children, but for most of them, the chance of returning to full health on their sixth birthday is slim. Families of sick youngsters will learn to dread sixth birthdays, when the Bad Fairy’s cradle curse will kick in and they start to pay their GP and prescription charges.

This is mad stuff. Our precious health budget must go to those who need the help most, not those who fall into a particular age bracket. We do need a universal healthcare system, which is free to all at point of entry. But we, as a society, will have to pay for it. Realistically that means higher taxes, or a universal, compulsory insurance system.

I’m up for it even though, right now, I’m a leech on the system. I don’t pay private health insurance because I reckon I can’t afford it. But I can afford a three-week holiday in the West of Ireland and private music lessons for my children and a new lavender velvet headboard for my bed. So what you’re getting down to are priorities. I’m not paying health insurance because I’m gambling I can get away with it. Although private health insurance is keeping one of my best friends alive through the services of a superb oncologist.

If I or my husband or one of my kids get sick we’ll rock up to a hospital and demand attention. We will have every right to it. But a society with a first-class universal health care system, free at point of entry would force middle-class families like us to pay handsomely for it through the tax system.

You haven’t faced me down, Mr Government. You’ve made a series of cuts to the sick and struggling to fund a classic political stroke, their very own GP card for all the little kiddies. Of course Fianna Fáil has the most form on this kind of stroke, but Labour has a few to its credit too (free university place, anyone?). Now Fine Gael has got itself a few focus groups and entered Stroke City.

Thing is, we’ve outpaced them. As the Seanad vote showed, we’re learning to deal in facts. We’ve spent the last five years repeating the hard lesson that you have to earn what you spend and by now we can say it on our own.

All we need to speed our recovery now is for the politicians to catch up.