In the Taoiseach's absence last week, I spoke of the estimated 700,000 people who were affected by some degree of poverty - many were also affected by unemployment - and the health problems associated with being unemployed.

This week, I will touch on the latest statistics to the effect that between 10% and 15% of people with jobs are at risk of poverty.

I imagine it is much higher. They are now known as the working poor and are barely above the threshold for a medical card. Going to see a GP and purchasing a prescription could amount to a quarter of their weekly income. In ten years, GP fees in this country have risen from an estimated €20 to €55. Some GPs still charge €60. In France today a GP charges €22. We now have a situation where people are choosing between paying their mortgage and going to see a GP. Once again, it looks as though the banks are winning out over the welfare of ordinary people.

Because of the exorbitant costs of seeing a GP, two distinct trends are now emerging in the nation’s health. First, a huge volume of people are cutting back on medication and trying to stretch it out. The big examples relate to medication for blood pressure and cholesterol. Pharmacists now report that many people, including those with chronic ailments and conditions such as asthma and heart problems, take their medication every other day in order to save going to a GP and paying for the medicine. Does the Taoiseach agree that those two trends are a ticking time-bomb for the nation’s health?

Customs officials informed me that in a three-month period last year they seized 300,000 prescription drugs. The Taoiseach and I are both aware of the many people who bulk buy cholesterol tablets, inhalers and antibiotics in Spain. Does he consider it just and fair that when every other worker in the country has been asked to take a substantial pay cut and almost all workers have had no pay increase for five or six years, GPs and pharmacists rip off working people by charging exorbitant prices? Last week a lady in Waterford with a take-home pay of €397 who came to see me had paid €137 to a GP.

When will the Government commence the reform of competition and practice in the health sector, as set out in the memorandum of understanding with the troika? The Taoiseach has been most proactive in meeting other demands of the EU and IMF. When will the Government move to extend the role of pharmacists as part of the primary care network by introducing initiatives such as medicine-use reviews, repeat dispensing and switching more medicines from prescription-only to pharmacy-only?

No more than anybody else, we are interested in protecting, in so far as we can, lower and middle income families. That is why there was not an increase in income tax. That is also why the minimum wage was restored and, in so far as possible, such arrangements protected.

That is illusionary.

The Government should have increased income tax for those earning more than €100,000 instead of asking the poor to carry the burden.

The increase in prescription charges will have an impact on the extent of prescribing that has been ongoing by GPs throughout the country. The trends are clear in that regard.

I refer Deputy Halligan to the budget day announcement of the review of fees and allowances payable to health care professionals. They include general practitioners, pharmacists, dentists, ophthalmologists, optometrists and dispensing opticians who hold contracts with the HSE. The Minister decided that a consultation process would commence on 13 December 2012 and would be completed by 11 January 2013. Health professionals were invited to make written submissions to the Department and the Minister. The review will encompass, but is not confined to, fees and allowances which have been reduced previously under the Financial Emergency Measures in the Public Interest, FEMPI, Act 2009. The consultation process ended on 11 January. When the Department has considered the various points raised in the submissions, the Minister, taking into account the requirements under the FEMPI Act, will determine what fees and allowances should be reduced and by how much, after which the rates will be set out in regulations. I am aware of the point Deputy Halligan raised and a resolution is already in train following a decision made in the budget that is currently being implemented in terms of submissions received by the Minister for Health.

I have been informed that competition law precludes the standardisation of GP fees. Am I correct in saying that? If that is the case, are we in a situation that, two years into the Government’s term of office and with all the cutbacks suffered by every other worker, someone can charge €50 or €60 for a three-minute consultation? I refer again to people who are just above the medical card threshold who are barely earning the minimum wage. How could it be justifiable that they would pay almost a third of their wages to go to a GP and then to a pharmacist for medicine when GPs, medicines and pharmaceutical outlays are cheaper all across Europe? It is immoral in the current economic circumstances that someone would charge such fees. Some friends of mine are doctors and I make it clear to them that I find it unacceptable that even as we speak some doctors still charge €60 in consultation fees. That is immoral and offensive for those who cannot afford to pay it.

Hear, hear.

As Deputy Halligan is aware, approximately 1.8 million medical cards currently exist. That is higher than has ever been the case in this country.

Many people are still waiting to hear whether they will get one.

A lot of people are waiting.

It is clear that people who are on lower income levels are eligible under certain conditions for medical cards. The Minister for Health has negotiated with drug companies to produce savings on drugs of-----

He also negotiated a €25 million pension a few years ago.

-----serious amounts in the region of €400 million in the coming years, with moneys coming through in 2013. The consultation process ended on 11 January. The submissions will now be reviewed by the Minister for Health and he will decide the level of fees and other changes to be made. The review is not confined to fees and allowances for those working in the public area. Deputy Halligan said GPs can charge certain fees for a three-minute consultation and that goes up the line in much higher proportions as well.