White Pledges to Bridge the Disconnect

May 30, 2014 § 1 Comment

Announcing I will be a candidate for Leader of the Labour Party alongside Dublin Lord Mayor Oisin Quinn, Senator John Giltory, Derek Nolan TD, Ciara Conway TD and Michael McCarth TD

Announcing I will be a candidate for Leader of the Labour Party alongside Dublin Lord Mayor Oisin Quinn, Senator John Gilroy, Derek Nolan TD, Ciara Conway TD and Michael McNamara TD

I am today announcing that I will be a candidate for the leadership of the Labour Party. My grandfather was an active trade unionist and a Labour candidate in this city in the 1950s. As a child I helped my dad canvass for the party. So I grew up with the principles of social justice, equality, and democracy.

These Labour values have been a progressive force in Irish life for over a century. They are as relevant today as they were at any time in our history. But we must attune those values to the very real problems of today, and to the challenges of tomorrow.

In last week’s local and European elections Labour suffered very serious losses. While we have strained the loyalty of our supporters on many occasions since we entered government in 2011, the scale of our defeat in the recent elections demonstrates a clear disconnect with our traditional support base.

Across Europe social democratic parties have been rebuffed in favour of a kind of ‘anti-politics’. Anti-politics will only lead to a more uncertain future: unregulated market-driven capitalism, a retreat from the public sphere, and system breakdown. I believe that social democracy is our greatest protection against such a prospect. The Labour Party from its inception, more than any other party in this State, has single-mindedly, consistently and without fear or favour, promoted the ideals of equality and justice for all.

Anti-politics robs us of ideals. As the great social historian Tony Judt has remarked: “Ideals matter: without idealism politics is reduced to a form of social accounting”.

We have an opportunity now to address the deep crisis for our party – energetically and openly. My task – our task – is to make the Labour Party – the party of social democracy – relevant again both to its core constituency and to the people of Ireland.

To do so, we will need the active support and involvement of all sections of our party. We will need to listen, and to empower our party representatives, members and supporters in a way that captures their energy and their idealism, and that renews their trust.

This calls for clarity about our fundamental principles and objectives; honesty about the future and what can realistically be achieved; and a shared vision for Ireland that takes us beyond the shocks of the economic collapse.

People have demanded political reform and constitutional change, and we must fight for its delivery. People have demanded a more equitable form of resource distribution, and we must use our role in government to vigorously make this case. But we also need to be straight with people about the limits of what we can achieve, and within those limits where the priorities should lie.

We must steady our resolve as a party, and as a party in government. This requires steely determination, strong negotiating skills, and an ability to resolve problems. I will bring those skills to the leadership drawing on my track record inside and outside of politics.

I want to pay tribute to the stellar contribution made by Eamon Gilmore at the helm of the Labour Party since 2007. He brought us to our greatest ever election victory in 2011.

Since then, as a party we have come through a testing period in government. We have suffered a traumatic election reverse, and we need to embark on a project of renewal. This begins with the choice of a new leader – a new voice, a new style, and a new approach.

I believe I am the right person at the right time to lead this project of renewal and restoration. I believe that I can be a bridge to the new generation that must lead Labour in the coming years.

I am looking forward now to the engagement we will have during the course of the campaign.

White Marks Major Progress on Universal GP Care with the Introduction of Groundbreaking Legislation

May 28, 2014 § Leave a comment

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Second Stage Speech – Dáil Éireann by Alex White TD

28th May 2014

It is my pleasure today to introduce the Second Stage of the Health (General Practitioner Service) Bill 2014 to the Dáil. The Bill will provide for a GP service to be made available without fees to all children aged five years and younger.

The key features of the Bill are:

  • It provides an entitlement for all children aged five years and younger to a GP service without fees;
  • It removes the need for children aged five years and younger to have a medical card or GP visit card under the GMS scheme to qualify for a GP service; and,
  • It provides that the HSE may enter a contract with GPs for the provision of this GP service to children and provides that the Minister may set the rates of fees payable to GPs for this service.

I am also very pleased to inform the House of the conclusion of a Framework Agreement with the Irish Medical Organisation (IMO) which sets out a process for engagement concerning the GMS/GP contract and other publicly funded contracts involving General Practitioners (GPs). This Agreement has been reached following a series of discussions with the IMO and involving the HSE and the Department of Health led by myself. The process got under way following my invitation to the IMO at their Annual Conference on 26 April 2014 to enter ‘talks about talks’. I am pleased that these talks have now culminated in the drawing up of this Agreement. The Framework Agreement sets out an agreed process for engagement on all aspects of the GMS contract with GPs, with due regard to the IMO’s role as a representative body of medical practitioners, and within the context of the provisions of the primary legislation that will underpin the introduction of GP care free at the point of access. I now look forward to a meaningful engagement with the IMO on the GP contract.

2. Background and Reasons for Introducing Bill

The Government is committed to introducing, on a phased basis, a universal GP service without fees for the entire population within its term of office, as set out in the Programme for Government and the Future Health strategy framework.

As announced in the Budget, it has been decided to commence the roll-out of a universal GP service by providing all children under 6 years with access to a GP service without fees. Additional earmarked funding of €37m was provided in Budget 2014 to fund this first phase. It is not funded on foot of savings implemented elsewhere in the health system. The 2013 Report of the Expert Advisory Group on the Early Years Strategy recommended providing access to GP care without fees to all children in this age group. There are good reasons to provide universal access to GP care in view of the health needs of that age cohort. The early identification of health issues at a younger age can mitigate or reduce the impact of ill-health later in life. We should bear this in mind, given that the Growing Up in Ireland survey has reported that almost 1 in 4 children in Ireland are either over-weight or obese, and the likelihood that this will lead to significant health issues later in life.

When this first phase is in place, approximately one-half of the population will be covered by a GP service without fees at the point of use. The Government is in the process of examining the next phases of extending the universal GP service.

Deputies will be aware that our current arrangement of health care provision can be traced back to the mid-nineteenth century with the 1851 Poor Relief (Ireland) Act, where limited services were provided to those who were unable to pay for them. This, speaking frankly, I find is astounding. I believe it is an anachronistic and inappropriate basis for a twenty-first century health system and is far from any comparable modern health system of any other European country. It underpins the importance of moving towards a health system based on universality of access. The concept of eligibility has been somewhat amended by legislation, most recently in 1991 and 2005. However, the fundamental principle of means-testing access to health services was retained by the Oireachtas on both occasions.

One result has been that the means-based legislative framework has produced a very complicated eligibility system, which must take account of a person’s “overall financial situation” as stated in the Act. This system is very likely to confuse, and almost certainly makes it impossible for a person to know whether they qualify for a medical card. It is quite clear from the real concerns raised by members of the public that there are difficulties for some persons with permanent conditions obtaining access to health services under the medical card scheme. This is a problem that we must address. It is being treated as a matter of priority by the Government, and I can tell the House that we are actively examining the issues and working towards a solution.

I have stated before that I believe that we must move towards a health system based on universality of access, which must be sustainably funded to enable the provision of services to meet health needs. I recognise that a move from a means-based eligibility system to a universal-based system of health coverage is difficult, and that many anomalies arise. Members and others are perfectly entitled in the course of the debate to point to these anomalies and contradictions as they see them. We must try as best we can to address these issues in a sensitive and pragmatic fashion. However, the Government’s commitment is to fundamentally reform the Irish health system in the way we have proposed. In that context, I would like to hear more from our critics about any alternative approaches they may have to the organising of health care coverage in Ireland, apart from maintaining the existing system.

It has been suggested – though perhaps not in this House – that people should be eligible for a medical card on the basis of their having a particular medical condition. On the face of it, it is manifestly right that if you have an illness you should be able to access the health service. This is of course at the heart of the reform we are seeking to bring about, and I passionately believe that it is something that we, as legislators, should strive together to deliver.

However, in seeking to supplement our current inadequate means-based system with an illness-based approach, there is a risk – a risk – that we could cause unintended consequences, and I think that we, as legislators, should examine and consider these risks when we are looking at changes.

Personally, I would not advocate an illness-based eligibility system as a long-term solution that would result in the health service inadvertently only treating people with certain conditions, while excluding people with other conditions from care. We are in the process of re-orientating the health system from one that only treats sick people to one that keeps people well. That is one reason why I believe that a universal system is the best option.

However, these major reforms take time. I think we should consider and explore how best the existing eligibility system can be adjusted to ensure the people on low incomes, or who have permanent or terminal conditions can obtain timely access to the health system. There is a good case to say that the existing eligibility system has become overly complex, resulting in people focusing on the assessment process rather than on the provision of services. I think we should not lose sight of the fact that an ill person should be able to receive primary health services in their own area. At the same time, we must remain steadfast, and committed to implementing the most radical reform of the Irish system in the history of the State – and to developing a universal system that treats all according to their health needs and not their means.

3. Summary of Substantive Provisions

The purpose of this Bill is to provide for a general practitioner service to be made available without fees to all children aged five years and younger. The Bill provides that the HSE shall make available a general practitioner service without fees to all children aged five years and younger.

The Bill also provides that the HSE will be entitled to enter into a contract with any suitably qualified and vocationally trained General Practitioner for the provision of GP services to all children aged five years and younger. However, the HSE may enter into a contract for relevant services with any registered medical practitioner who already holds a GMS contract for the six month period following commencement of the section. Such a contract shall specify the services to be provided by the GP.

The Minister for Health may by regulation, with the consent of the Minister for Public Expenditure and Reform, fix the rates of fees and allowances to be paid to GPs for services provided under these contracts. The section requires that the Minister in making a regulation for this purpose must engage in consultations, and it prescribes the role of the Minister and HSE, the nature and manner of the consultations, and the considerations to which the Minister must have regard in making regulations. Where the rates fixed by regulation under this section are varied under subsequent regulations, a GP who does not wish to continue providing services may terminate his/her contract by giving the HSE three months’ notice.

As all children aged under 6 years will be covered by the new GP service under this Bill, it removes children who have not yet attained the age of six years from the existing GP service under the medical card scheme. However, it is important to be very clear that children aged under 6 will continue to qualify for medical cards, and their entitlements to other health services, such as prescription drugs, will not be affected in any way.

Among the other provisions of the Bill are amendments to the existing legislation relating to appeals under the Health Act 1970. It provides that the current HSE appeals process be extended to decisions regarding the operation of the new GP service for all children aged five years and younger, and also provides that the Director-General of the HSE appoints persons to carry out appeals. It clarifies that where the person carrying out an appeal is an employee of the HSE, that person shall hold a grade senior to the original decision maker. The existing provision in the Act that the Minister may make regulations in respect of the appeals process is re-stated without change.

The Bill also amends the existing ‘ordinarily resident’ framework in the Health Act 1970 to reflect changes made in Section 2 and extends the framework to include the new GP service for all children aged five years and younger.

Before I explain the main provisions of the Bill, I wish to advise the House that the Heads of the Bill were forwarded to the Committee for Health and Children for pre-legislative scrutiny. Unfortunately, this was somewhat delayed as operational protocols regarding pre-legislative scrutiny were not yet available at the time. As a result, the Bill was published by Government before the committee had had an opportunity to discuss the proposals. However, I do look forward to detailed discussions with Deputies at the committee stage of the Bill.

Section 2 amends the existing legislation relating to appeals under the Health Act 1970. It provides that the current HSE appeals process is extended to decisions regarding the operation of the new GP service for all children aged five years and younger and also provides that the Director-General of the HSE appoints persons to carry out appeals. It clarifies that, where the person carrying out an appeal is an employee of the HSE, that person shall hold a grade senior to the original decision maker. The existing provision in the Act that the Minister may make regulations in respect of the appeals process is re-stated without change.

Section 3 amends the existing ‘ordinarily resident’ framework in the Health Act 1970 to reflect changes made in Section 2 and extends the framework to include the new GP service for all children aged five years and younger.

Section 4 removes children who have not yet attained the age of six years from the existing GP service under the medical card scheme under section 58 of the Health Act 1970, as they will be covered by the new service under section 58B. As I mentioned above, it is important to be clear that children aged under 6 will continue to qualify for medical cards and their entitlements to other health services, such as prescription drugs, will not be affected in any way.

Section 5 provides for the insertion of sections 58B and 58C into the Health Act 1970.

Section 58B provides that the HSE shall make available a general practitioner service without fees to all children aged five years and younger. It provides that a parent or guardian of a child seeking access to this service should provide to the HSE such evidence as it considers necessary to demonstrate entitlement to the service, and where such evidence is not provided the HSE may treat the child as if he or she is not entitled to the service. Where possible, the HSE will offer a choice of GP to those accessing this service.

Section 58C provides that the HSE will be entitled to enter into a contract with any suitably qualified and vocationally trained General Practitioner for the provision of GP services to all children aged five years and younger. However, the HSE may enter into a contract for relevant services with any registered medical practitioner who already holds a GMS contract for the six month period following commencement of the section.

The contract shall specify the services to be provided by the GP. The Minister for Health may by regulation, with the consent of the Minister for Public Expenditure and Reform, fix the rates of fees and allowances to be paid to GPs for services provided under these contracts. The section requires that the Minister in making a regulation for this purpose must engage in consultations, and it prescribes the role of the Minister and HSE, the nature and manner of the consultations and the considerations to which the Minister must have regard in making regulations. Where the rates fixed by regulation under this section are varied under subsequent regulations, a GP who does not wish to continue providing services may terminate his/her contract by giving the HSE three months’ notice.

Section 6 is a technical amendment necessary to enable the seamless implementation of section 2, which extends the existing eligibility appeals process to the new GP service for all children aged five years and younger.

Section 7 states the short title of the Act, provides for the collective citation of this and prior Health Acts as the Health Acts 1947 to 2014 and includes a standard provision relating to commencement of the provisions of the Bill.

4. Conclusion

In conclusion, the main purpose of the Health (General Practitioners Service) Bill 2014 is to amend the Health Act (1970) in order to provide for a general practitioner service to be made available without fees to all children aged five years and younger. The Bill provides that the HSE shall make available a general practitioner service without fees to all children aged five years and younger.

The Bill also provides that the HSE will be entitled to enter into a contract with any suitably qualified and vocationally trained General Practitioner for the provision of GP services to all children aged five years and younger. However, the HSE may enter into a contract for relevant services with any registered medical practitioner who already holds a GMS contract for the six month period following commencement of the section. Such a contract shall specify the services to be provided by the GP.

I commend the Bill to the House and look forward to hearing the views of Deputies.

Positive Results for our Local Labour Team in DLR

May 25, 2014 § Leave a comment

Peter O'Brien Photo

I’m deeply impressed by the support given to our candidates in the Dun Laoghaire-Rathdown Local Elections – Cllr. Grace Tallon, Cllr Lettie McCarthy, Cllr Richard Humphreys, Peter Leonard and Peter O’Brien – and delighted with the return of our three sitting councillors in Dundrum, Stillorgan and Glencullen, who will be joined by a fresh voice, newly elected, Cllr Peter O’Brien pictured here with his electoral team early this evening at the count centre, Citywest.

Vote No. 1 for your Local Labour Team

May 20, 2014 § Leave a comment

The hallmark of Labour councillors, has and always will be, their hard work and dedication to their local communities. That is what Labour councillors do. They work day after day on the issues that matter most to people in their local areas.

Cllr. Grace Tallon, Alex White TD, Cllr Lettie McCarthy, Emer Costello MEP and Peter O'Brien

Cllr. Grace Tallon, Alex White TD, Cllr Lettie McCarthy, Emer Costello MEP and Peter O’Brien

I know this is true of Labour’s local team in Dun Laoghaire-Rathdown. Cllr. Lettie McCarthy, Cllr. Grace Tallon and Cllr Richard Humphreys have demonstrated their work ethic, integrity and commitment to their local communities. I am hopeful that their efforts will be recognised by the electorate on Friday. Additionally, two new candidates have put themselves forwardPeter O’Brien and Peter Leonard; their vibrant and energetic campaigns coupled with their enthuasism and ideas have garnered a positive response on the doorsteps.

Alex White TD canvassing with Peter Leonard

Alex White TD canvassing with Peter Leonard

The Labour Party has an honourable and honest track record in local government across Dublin. Labour has an unrivalled record for good, sensible, sustainable planning, and the Labour Party can be proud that no Labour councillor has ever been found to have taken a corrupt payment.

There has never been a “for sale” sign on this Party, and there never will be.

Cllr Richard Humphreys, Emer Costello MEP and Alex White TD

Cllr Richard Humphreys, Emer Costello MEP and Alex White TD

We are working together to get more local jobs; better transport; better housing; and safer, greener communities. I ask you to cast your No. 1 vote on Friday for your local Labour team in Dun Laoghaire-Rathdown.

Labour is Working - Communities

Eight More Schools in Dublin South to Undertake School Improvements

May 2, 2014 § Leave a comment

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I warmly welcome the announcement by Ruairí Quinn T.D., Minister for Education and Skills, that a further eight schools in Dublin South will be able to undertake school improvements this summer as part of the second round of the Summer Works Scheme.

Eight local schools will receive money to improve and upgrade existing school buildings and in particular to refurbish toilets and roofs.

The successful schools in securing funding under the second round of the Summer Works Scheme are St Attracta’s Senior National School in Dundrum, Scoil Mhuire in Ballyboden, Scoil Na Maighdine Mhuire in Balinteer, Edmondstown National School in Rathfarnham, St. Brigid’s National School in Stillorgan, Whitechurch National School, St. Mary’s National School in Lamb’s Cross and De La Salle College in Churchtown.

Approximately 1,440 pupils in Dublin South will benefit from these improvements making their schools a better environment to learn in.

These works will be carried out in schools over the summer months, when the pupils and teachers are on holidays, so the disruption to schooling will be kept to a minimum.

This Government is committed to investing in our schools and ensuring that despite economic constraints, young people can learn in safe and secure buildings. The Summer Works Scheme also acts as an important boost to the local economy, through the creation of jobs in the construction industry.

In total, more than €70 million has been allocated to the first and second round of the Summer Works Scheme 2014.

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