I join Deputy Kenny in wishing the Taoiseach well in today's endeavours. I confess that I am a little taken aback by the Tánaiste's remark that it should not be assumed that all that remains at issue is the question of photographic verification of decommissioning. I was under that impression, given that the Taoiseach said at Question Time yesterday that there was one outstanding issue and all the media reports are to the same effect. I am not quite sure that I understand the Tánaiste's remark. However, the Labour Party wishes the Government success in its important endeavours.

I want to ask a question regarding the 200,000 people who now face the prospect of increased drugs bills and increased accident and emergency charges on 1 January while still having to pay €40 or more to visit a doctor. This comes about because the changes announced in the budget are to be implemented on 1 January, whereas the yellow-pack medical card, the doctor only medical card, may require primary legislation or other administrative changes which the Government is not yet ready to bring before the House.

I draw the attention of the Tánaiste to the drugs refund threshold spiral in recent years. On 1 June 1997, it was €38; on 1 June 2002, it was €53; on 1 December 2004 or from 1 January 2005, it will be €85. That is an increase of €47 per month or 123% since 1997. The accident and emergency charge increased from €15 in 1997 to €31 in June 2002 and will increase to €55 on 1 January 2005. That is an increase of 261% in that period. Of course, the cost of VHI has increased by 100% since 1997 and will rise again by approximately 5% following the increase of 25% in the cost of private beds. All of those increases will go ahead on 1 January next. People will have to pay to visit a doctor because the Tánaiste's legislation will not be before the House. Will the Tánaiste respond on this and state whether, at a minimum, she will postpone the implementation of the charges until such time as the yellow pack cards are legislated for?

Some 1.2 million people do not or will not have to pay any drug charges. The increase is €7 per month, whereas in the United Kingdom the charge is £6.20 sterling per prescription, which is approximately €10. Some 30% of those who visit a doctor never acquire a prescription. Therefore, in making choices for next year, the Government decided to extend the doctor only card to as many low income families as possible, particularly those with children.

This does not require primary legislation, only the signing of a statutory instrument, which I intend to do immediately. Obviously, we must advertise and seek applications. It is normal, when one is extending a service on a different basis, that this would take a number of weeks into the following year. It will probably be the end of February or the beginning of March before people begin to receive the doctor only cards.

Given that the Tánaiste now admits that the doctor only card will not be introduced until the end of February or the beginning of March and having regard to the fact that we waited 18 months for the Bill on the restructuring of the health services, it is obvious the Tánaiste should not implement the increases on 1 January. It is well for her to talk about the increase being only €7 and so on, but I detailed the figures. There has been rapid escalation since 1997 in costs associated with visits to accident and emergency units, the drugs refund threshold and VHI. However, the Tánaiste intends that where people on very low incomes do not qualify for a free visit to the doctor, they will also be charged increases on the drugs refund threshold, including in the event of them having to visit accident and emergency. The simple solution is that until such time as the legislation goes through the House, the new increases ought not to be implemented.

I do not accept that. As I stated, the current position is that 1.2 million people, a considerable number, will pay no drugs bill. The doctor only card will be of great benefit to low income families with children who want reassurance from a doctor and want the opportunity to visit a doctor without having to worry about the cost. Charges have increased but the taxpayers' investment in health care has increased by an even greater margin, to over €11 billion next year, which is threefold the amount available seven years ago.

The poor pay.

Health care is expensive and we must make choices.

The health service is inefficient.

In most countries, people must pay all along the line, including those at the very bottom who must make a small contribution towards prescriptions. In the UK, one must pay £6.20 sterling, approximately €10, for each prescription.

What has that to do with the issue?

We do not live in the UK.

What of Boston and Berlin?

The UK only has the NHS.

The Tánaiste without interruption, please.

: They do on the NHS.

What has that to do with the increases here?

This is Deputy Rabbitte's question. Only Deputy Rabbitte is entitled to ask a supplementary question.

We are looking for answers.

The Government has limited resources available to it and it makes choices based on those resources.

The Government said that money was coming out its ears.

Most have welcomed the doctor only card and there is huge interest in it among the public.

They will not get it.

They will get it as quickly as possible.

Independent Deputies and socialist Deputies-——

They are not all socialist.

We are united, Deputy Hayes.

Deputy Joe Higgins is not on his own.

Deputy Conor Lenihan ran out of steam last night.