Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I join the Cathaoirleach in welcoming the Minister, Ministers of State and Mr. O'Brien along with their colleagues from the Department and the HSE. I join the Chairman in congratulating Mr. Tony O'Brien and I wish him success in his now confirmed role as director general of the HSE. I also wish to be associated with the expressions of thanks and good wishes to Ms Mary Lindsay.

I wish to raise with Mr. O'Brien the HSE report on medical cards and the recent focus on discretionary medical cards for people with what are termed terminal illnesses. There is a particular focus on children with what I prefer to term life-limiting conditions. I ask Mr. O'Brien to define "terminally ill". I believe there is clever use of language to avoid facing up to the fact that the statistics confirm, as Ms McGuinness outlined at a recent meeting, a significant reduction in the exercise of the discretionary granting of medical cards in these circumstances. I have met parents of children with what I would call life-limiting conditions, including cancer with all that entails, who have not received medical cards. They have either been withdrawn or they are continuing through a process of appeal having had them refused in the first instance. It is a terrible situation for those families, many of whom are only marginally outside the qualification threshold. It is unacceptable.

There is a need to define "terminally ill" and, if possible, to differentiate it from "life-limiting". The truth needs to be faced in this regard.

It would be remiss of us if we did not also ask the director general designate of the HSE and the Minister to address briefly before the meeting concludes what can only be described as the compounding exposure of the fact that the wrong scope was identified as the problem in the colonoscopies carried out on children at Crumlin hospital. It is important that this issue be addressed and that an explanation be given. In many people's minds, there is no better example of what appears to be gross carelessness. For the 18 families contacted yesterday, no list of excuses could possibly mitigate the consequences of labelling the wrong scope as being at fault. It is harrowing, yet their children were not the ones at risk. Seven new families needed to be contacted yesterday evening. Rather, six have been contacted and one is still being sought. We need to know what steps have been taken to avoid the compounding of the problem that presented in the first case by the identification of the wrong scope and the consequences of same.

Before going into each question and reply, the replies that I have received to my questions have been most unsatisfactory. In fact, two have been derisory. I have no other way of describing them. It is grossly unfair to members of this committee who have put so much work into preparing their questions, researching the issues and contributing to health debates and legislation that we are given such cursory replies, some of which ignore the core of what we are trying to establish.

I wish to deal with question No. 12 on the national dementia strategy. The reply sets out the scale of the problem of dementia, which is considerable and is set to grow in the coming years. We all know this. The reply reminds us that the programme for Government is committed to developing a national Alzheimer's disease and other dementia strategy by this year. However, the reply also states the intention that a draft strategy would be completed by the end of this year. We are clearly not going to have the strategy in situif we are only going to have a draft strategy by the end of this year. There is no word of when we can expect publication of the strategy and, crucially, no mention whatsoever of an implementation plan. I ask that this issue be addressed by the Minister and the director general designate.

There are fine words in the reply, for example, "practical focus" and "action oriented". If we consider what is actually happening - some of us have personal experience and are coping with situations of dementia presenting in our families - I am deeply concerned that the actions being taken in tandem with these fine words run contrary to the strategy's stated intent. I wish to draw the Minister's attention to the home adaptation grant scheme, which is a current issue. It was drastically cut by 38% by the Government this year. Only yesterday, Dublin City Council announced that the scheme was closed for 2013 because it had run out of funding. There is no money available.