Bernard Durkan (Kildare North, Fine Gael)
Link to this: Individually | In context | Oireachtas source

I thank the witnesses for their work and successes. I will not mention any failures because I am sure there are none but we will discuss some of them. My colleague has just raised a matter that I have raised on several occasions, namely, that of medical cards in special circumstances. Mr. Gloster replied that there are more medical cards available now. That is not an answer to the question, however. There are more medical cards available now but there is a bigger population, more demand and more need for medical cards. The points made by my colleague are relevant. In the cases with which I have dealt in recent years, everything was done to make sure the financial situation was met but everything else was left to one side. The patients were told the matter was being considered but they would have to make a new application. If they still did not meet the financial limits having made a new application, they were told to make another application. It is absolutely heartless to tell a person who has a life-threatening condition, to say the least, that the HSE is very sorry but he or she does not qualify and that if he or she works hard at it, the HSE will reconsider the matter at a later stage. That is not acceptable and something needs to be done about it. The person has the added burden of not knowing where he or she is going. These people cannot foretell their future. The burden of the illness is on them and they are conscious of the extra medical and other costs, as well as having to take time off work and so on. All that needs to be taken into account. I dealt with a case in another area where a senior official in the HSE was in that situation and gradually, through a number of years, was ground down to the stage where he or she had to sell his or her house to pay for medical expenses as he or she did not qualify on financial grounds. There is a need for that to be considered further. As my colleague stated, that needs to be done urgently.

It is many years since the criteria were shifted significantly in terms of qualification and eligibility for a medical card. That needs to be looked at again as a matter of urgency. There is no sense in the HSE repeating that it is doing its best and knows the situation that exists and so on. The people who have life-threatening or life-changing medical conditions need consideration now and we need to be able to say and do something about it. I have raised this issue on several occasions in the past, as the Cathaoirleach is aware, and will do so again. I do not want to have to raise the issue again. I abhor the notion of bringing up a particular case to further length. Enough is enough. This should be done and I hope that it will be done as a matter of extreme urgency. I spent three days at this time last year pursuing a particular case where there was a stone wall, with no response whatsoever. I had to take time out and hunt down the various individuals who were responsible. I eventually got it resolved but it should not take three days of a public representative's time for that to happen. I know the time of public representatives is not very important but it is important to me. The issue should be dealt with as a matter of urgency and progress in that area should be made before the next meeting.

I thank the witnesses for the reply I received regarding Naas hospital. I mentioned the matter several times in passing with the sole objective of bringing forward the proposals that were in the pipeline and had been mulling around there for several years but, for various reasons, did not get the nod of approval. Everything was grand except for one thing. The issue of procurement raised its head in the reply to my parliamentary question. In order to ensure progress is being made at a reasonable rate not only in respect of Naas hospital, but also in respect of all other projects that come up for review, we need to move ahead of the posse and identify not what the needs are now, but what they will be next year and the year thereafter. Things do not happen overnight. It is not rocket science. I ask the powers that be to take time to address this issue. When I saw the procurement procedure mentioned in the reply to the parliamentary question, I thought this was the final obstacle. We now know about that final obstacle for next year and the year, two years or ten years thereafter. I ask for that final obstacle to please be eliminated in sufficient time to ensure the projects go ahead. Incidentally, we cannot afford to wait any longer for the assessments of those projects to take place. Again, it is not rocket science; it is simply that we need to identify the needs. In places such as the greater Dublin region, there is severe pressure from population increases. We are at the coal face. It happens daily. It is no good saying it is an area with extreme population expansion in recent years so there are problems there. That would be looking back on it. Let us look forward and deal with the thing before it becomes an obstacle and a problem. It is about forward planning. I ask that particular note be taken of that issue. When the witnesses report back to the committee, I hope we will see a reasonable expansion of expectations. That is only expectations; I have not dealt with the reality of delivery just yet.

I congratulate all those involved in the progress to date in respect of Sláintecare and the movement in that direction. I congratulate Mr. Gloster on the action taken in respect of the bank holiday overspill that we have come to expect regularly. The application of simple measures - again, it is not rocket science - had a dramatic effect, and will always do so. I thank all concerned, including those on the front line who volunteered and gave extra services to deal with the job that is there. It is becoming more of an issue that health issues arise 24-7. When matters have to be postponed to the next week, month, year or whatever the case may be, the system is not up to speed. Mr. Gloster and the staff did well in those situations and I thank them for that. He can take a bow, unless he will bump his head while doing so.

There are more improvements we can-----