Billy Kelleher (Cork North Central, Fianna Fail)

The report I got from the Department states that the process was not correct in requesting further information. That is one of many such cases. We have heard of case after case from Deputies who consistently raise the issue of medical cards not being processed in time. People who are ill and who received medical cards because of their illness have to wait for a long time before renewal and in the meantime have to pay for their own medicines. This is a cost-saving measure by stealth and it is unacceptable. The delay in processing medical card renewal forms is an attack on the most vulnerable.

The Minister promised he would address the fair deal scheme. There are inordinate delays in processing applications under the scheme. This issue was raised last July and the Minister said he would get to grips with it but unfortunately people have to wait an inordinate length of time for their applications to be processed. This is unacceptable in the current climate in the context of the service plans announced by the HSE and regional plans flowing from that, given that the Minister will announce the closure of up 900 community and residential long-stay beds. If that goes ahead, the Minister will face a major difficulty in acute hospital settings because he will not be able to move people on. He said in Opposition that it was fundamentally important to have long-stay and step- down facilities in order that people could be moved from acute hospitals into long-stay and residential care. Now in the same breath he is saying that we can work without up to 900 beds in residential and community care. It is unacceptable. The way this policy was handled to date has caused difficulties, as the Minister will be aware from the difficulties in Laois and concerns in Dublin and in Louth. What is proposed is perceived as almost an attack on communities. There is also the matter of the way it was announced and handled. People had to go to court to protect what they considered to be their home. The Minister deep down would oppose what is being proposed vehemently if he was on this side of the House. All I am doing is raising these issues. Dismissing legitimate concerns of Members of this House is unacceptable when people are genuinely trying to be proactive in highlighting the inadequacies of the health service.

Front-line services are a key component. The Minister was strong and vocal on this issue in the past. He was quoted as having said it is not always about balancing the budget; front-line services are the most important vehicle for the delivery of medical care in this country. There is a fundamental attack on front-line services. The Minister knows full well that on 29 February there will be a major void in the capability of the health services to deliver emergency and maternity care. All of his statements that he has a plan simply do not add up. If he had a plan, I am quite sure it would have been announced and published at this stage, along with a photo opportunity, but we have not seen one to date. I ask him to ease the fears not only of those who may be dependent on the health services but, more importantly, of those who are working on the front line and are expressing grave concern. The Minister has dismissed the comments of some senior obstetricians and professors of gynaecology and obstetrics, but if he talks to maternity nurses, he will find they are very concerned about 1 March.

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