Joe Sherlock (Cork East, Labour)

I wish to share time with Deputy Lynch. The Bill will amend the Health Act 1970 to address two matters — the charging of patients for maintenance and inpatient services in residential hospitals and the introduction of doctor only medical cards. The issue of who is entitled to be refunded as a result of illegal charges in community hospitals where contract beds were provided is clear but many elderly people were told they had to take beds in private nursing homes because no beds were available in community hospitals. One can imagine the trauma experienced by elderly people who knew their own families were involved in debating with the liaison officer at the time. They accepted the transfer because they had no choice. They were given application forms, which were all but signed for them in many cases. They had no choice but to accept a private nursing home. Over the years the Government provided private nursing homes and provided substantial tax breaks to private enterprise to build them but the Government did not consider nursing home subvention payments. The families of elderly people transferred them to private nursing homes but did not realise the subvention payments were much less than the weekly cost of care in the homes. In some cases elderly people were forced to sell their homes to pay the charges. Most people I know from rural areas in my constituency had to sell their cottages, even though they were entitled to full subvention because of their medical needs.

The Labour Party does not object to charging elderly people through deductions from their pensions but we are seeking justice and fairness for everybody. I followed this issue closely as a former member of the Southern Health Board. The former Ombudsman stated that under section 52 of the Health Act 1970 an elderly person in need is entitled to inpatient accommodation in a public or private nursing home. I hope the Minister of State will address this issue when he replies. Will people who were resident in private nursing homes receive refunds? It is staggering to consider that the previous Minister for Health and Children, Deputy Martin, spent €30 million on consultant reports but continually ignored the issue of nursing home charges.

I refer to the provision of doctor only medical cards. The saddest aspect of the nursing home scandal is that medical cards provide good value for money, speedy access to GPs and can reduce the cost of prescription drugs and hospital charges for individuals and families on low incomes. A few years ago 39% of the population had medical cards. I remember approximately eight years ago it was 49%. I understand that it is now 27%, and that gives one an idea of what has been happening. Many people who find themselves marginally over the limit are refused a medical card and are offered doctor-only cards instead. The Minister says this allows a patient to avail of a doctor's services for free and to claim back the cost of drugs in excess of €85 a month. I am well aware that there are people who do not have a medical card who visit doctors and do not go to the chemist because they cannot afford the drugs. They are marginally over the limit. In my region there is a community welfare officer, a superintendent community welfare officer and a referee. There was a time some years ago when one person would do all that in his or her own time. It might have taken a little longer but that person knew what was happening. They did not have the problems we do now.

In 2001 we were told that every person over 70, irrespective of wealth, was to have a medical card. That the cost of the scheme was underestimated is a further example of the maladministration of this Government. I listened to the Minister's colleague, Deputy Dennehy, speak at length on the subject, but he did not know what he was talking about. I would give the following example. A person refused a medical card because of being marginally over the limit went into a chemist despite the fear that it would be impossible to pay. Beside that person was a farmer with three farms and one of the wealthiest people in the locality. He presented his medical card to the chemist while the other person could not afford what was prescribed. That is not an exaggeration, and that is the issue. A means test should have been carried out to determine whether the person was entitled to a medical card. For people on fixed incomes, it is simply not possible to pay prescription charges even though general practitioner charges are covered by these new cards. The scheme does not work for those on a low income.

I know that the Minister will address these questions when replying. I have said over the years, especially during health board meetings, that the way the most vulnerable elderly people have been treated in terms of health services is appalling. The current Health Service Executive is not inspiring confidence.

See this speech in context