Bernard Durkan (Kildare North, Fine Gael) | Oireachtas source

I do because this morning's discussion would see the need for setting up a new department of frustration where public representatives who have raised questions, such as those we have been listening to this morning, including those raised by the Minister, could vent their frustration rather than allow it to affect their health. We have dealt with an important issue this morning. I am not joking about this because all of these issues have been raised again and again and it is like dragging a donkey through a bog. It is so slow getting to the nub of the conversation and the person who might be responsible.

For example, I mentioned reimbursements earlier, as did other members, and we saw in recent days how certain reimbursements in respect of treatment outside the State were not made at all, even though they are due and are entitled to be made or else the patient should not have been sent abroad in the first place. It is extremely trying for public representatives and Ministers to tell the public that a matter is on the long finger but that they do not know how long the finger is and when a resolution to it will be reached. The time has come to cut to the chase and let people know that they should not have to go to the Ombudsman to get paid. First, it is important from the point of view of the standing and good name of the State. To get the reputation of not paying one's bills is not something we should be into.

I mentioned reimbursements - I spoke to the Minister privately regarding this - in respect of people who have had life-threatening or life-changing conditions and have looked for a full medical card but have been refused again and again. I would love to know what the people who make these decisions do for recreation because what they are doing is tormenting people unnecessarily. In those situations, what is needed is to look beyond the income of the household. That income may be above the income guidelines, which, incidentally, are not very high either. We should look beyond that and look at the hardship side of it.

The hardship area covers a multitude, including medical cards and particular, specific issues, but it is impossible to find somebody to answer a question straight. We can table all the parliamentary questions we like, and I raised some of these questions under Topical Issue Matters as well, to try to concentrate on a particular issue, but nobody cares. Nobody bothers and nobody tries to go down to the individual patient and say he or she is suffering from a very serious illness or an accident that occurred in hospital. He or she may have complied with all the issues, including providing a GP report, a hospital report and every possible piece of information that could be necessary. What is the answer? He or she to make a new application. Appalling carry-on like that is going on. It is repeating the dose again and again and sending the person around in circles. I am beginning to get very angry about it. I am not blaming the Minister or any individual for it but I will tell him one thing: it will come to an end very quickly. There needs to be a direct address of that issue in the short term.

I will finish on one other matter, that of primary care centres. We need to know more about the roll-out of primary care centres throughout the country. We also need to know more about the extent of the facilities in the individual primary care centres and how well they are working. Are they all of a modular construction so that, for example, in later years, if it is necessary to add on to a particular centre, it can be done without having to wait four or five years to do it? Some of the primary care centres I know are very successful and do a great job. The original intention was they would replace accident and emergency departments, to some extent, and GPs could work from them and provide a greater level of care as a result. I recall being in a primary care centre equivalent in Northern Ireland some years ago. I was very impressed. All services were provided, including out-of-hours services on a Sunday afternoon. There was no question of having to find a hospital for someone to go to at that stage of the day. There was none of that kind of nonsense. The patients were attended to straightaway. These were simple issues that could be simply dealt with. I know all primary care centres are not similarly designed. I believe they should be, within reason and within site constraints and so on but, for example, there should not be a vast difference between them. Someone should not have to climb a ladder, or go up a long stairs or lift or something, to gain access to the place. The patient has to be considered. How do the patients feel when they come on-site? The patient may be in a wheelchair or on crutches, whatever the case may be. We need to consider the point of view of the patient.

The Minister raised the issue of scoliosis, spina bifida and so on and so forth. We have talked about that subject many times at this committee over the past number of years. We had a consultant who did some experimental work and carried out the services, to a great extent, for a limited period. However, for whatever reason we do not know, it was decided to again put this on a waiting list. It is the old long-finger stuff, as far as I can see. Again, we do not even know how long that finger is. There is a necessity to ask whether we have the facilities, people and personnel ready, willing and able to carry out this very much sought facility for quite a large number of patients and children who require the service now and not in some far-off distant future that nobody considers. To a patient who has a severe illness, six months is a long time. A year is a long, long time and it goes on for longer than that as well. I ask the Minister to call in those responsible to say we have had enough of this nonsense. Let us do it now. Let us show the public that we can do this in the way we should do it in the shortest possible time.