John Dennehy (Cork South Central, Fianna Fail)

Deputy Sherlock's party was on our side for a long time until we granted the cards and then the party voted against us in the House. I believe the IMO is in favour of this scheme. I am sure it will get the same rate as usual.

I welcome the review of eligibility guidelines for the full medical card. It is expected that at least 30,000 additional people will qualify. The actual increase is 7.5% on the 2004 figure. Two of my former Southern Health Board colleagues are in the House. We had concerns about how the guidelines were reviewed every year by the eight CEOs because their aim was probably to keep the budget as low as possible. The increase was usually 2.5%, but this year it is 7.5%. That will be of considerable benefit.

A great deal of honest comment and input is required if we are to succeed in establishing a proper system of care for the elderly. People are living longer and our elderly population is growing as a percentage of the population, which may create financial problems. The fiasco of the figures supplied for the over-70s medical cards should not prevent us looking at schemes like this.

Similarly the figures were incorrect in regard to the initiative which the Government took to benefit old age pensioners living abroad, also people who had built the State. Again, the figures were all wrong but the concept was right. It was the correct thing to do. We must provide for a proper service in the future. We have never achieved this to date.

The reason we have so many private nursing homes is that the State has failed to provide sufficient long-term care beds. Something has been achieved in terms of acute hospital beds but we have never attempted to provide step-down facilities. We have never handled it properly and we will have to look at that. Private nursing homes have filled that void, admittedly at a cost. They have done a good job. We are facing a changed situation. The age profile of the population is changing. The people who would have looked after family members in the home are no longer there. People are now going out to work who previously would have stayed at home. Many other factors also come into play.

We will have to look carefully at other options. I refer to home help and home care packages which appear to offer a solution in that people would be paid to provide a facility and the back-up service would be provided by local authorities. We will have to make decisions and take action quickly on these options.

It would be wrong of anybody to suggest that we should give somebody who is in full-time care their full old age pension to be put aside for other family members.

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