Medical cards: The Minister for Health, Mr Martin, has staunchly defended the Government's much-criticised decision to give medical cards to over 70s at a time when families with young children needed them just as much. or even more, writes Eithne Donnellan, Health Correspondent.
In a wide-ranging interview with The Irish Times, Mr Martin said there was a myth going around that the State's elderly population was very wealthy. "The vast majority of the elderly are not on high incomes ... and quite a substantial number of over 70s were already getting the medical card prior to the overall extension to the over 70s," he said.
But he acknowledged there were "issues" around the extension, including the fact that the State underestimated by more than 30,000 the numbers of over 70s who would benefit and, as a result, the move cost some €50 million more than was anticipated.
"Well, there are issues around that certainly in terms of identifying the numbers out there and so on but some day I'll tell the full story on that. I have my own theories about all that," he said.
An independent review has already found the Department of Finance told the Department of Health only "a few days prior to Budget Day in December 2000" of its decision to extend medical card eligibility to all over 70s and the Department of Health had a very short time to assist Finance to determine the likely cost.
If a private company got figures so wrong, wouldn't jobs be on the line? "I love this question about the private company... if the public sector did half the things some of the private companies do we wouldn't last kissing time. Certainly in Dáil Éireann, we wouldn't last kissing time," Mr Martin responds.
He insisted giving medical cards to over 70s made a statement about how we as a society treat our elderly. In addition, he said, it uncovered the fact that GPs were being paid for thousands of "ghost" patients.
While people asked why should an older man with a Mercedes have a medical card, they didn't question why such a person was also entitled to free travel or if free travel should be given to people on social welfare rather than older people, he said.
So should a well-off older man with a Mercedes have a medical card? "Most of those don't use their medical cards... they will go off to the Blackrock Clinic. But I think the vast, vast majority of older people are not in that league and I think we need to keep some sense of perspective on the debate," he said.
Mr Martin stressed that medical card eligibility should also be extended to poorer families. "I don't think it was an either or situation. I do believe we should extend the thresholds. I'm on the record as regretting the fact that we hadn't in the fiscal envelope of 2003/2004 had the resources to do it," he said.
There was an issue about the extraordinary growth of the General Medical Scheme in recent years, which was not just related to the over 70s as some people claim. "It's about increased rates of prescribing and increased costs of drugs. That all retarded our capacity to do it but anyway the bottom line is yes we should extend it and I would be hopeful that we could do it."
How soon? He said he was not in a position to say "until the estimates process begins".
Meanwhile, on the issue of what he is going to do in relation to ongoing difficulties at Cavan General Hospital, where there have been concerns around safety since the death of nine-year-old Frances Sheridan, the Minister said addressing concerns was not just about putting in more resources. "There always tends to be a knee-jerk reaction when things go wrong to blame it on resources. That's the tried and tested response but that's not the full story.
"There are issues around governance, peer review audit, and so on which should be happening irrespective of increased resources," he said. Furthermore, he said he had made it clear to the North Eastern Health Board the governance structures which should be in place at the hospital. This included involving clinicians in management.
Would staying on be fatal to Martin's political health?: page 5