Jimmy Devins (Sligo-Leitrim, Fianna Fail)

I welcome the opportunity to speak on this important and topical Bill. It is important and topical because of the immediate impact it will have on the lives of many people. There are two aspects to the Bill and I would like to deal first with the section on long-term stay.

Every Member of the House will be aware of the decision of the Supreme Court regarding the Health (Amendment) Bill 2004, which was passed by this House just before Christmas. While most media attention has focused on the findings of the Supreme Court that retrospective charges are unconstitutional, another finding by the court which received much less coverage is that the practice of asking patients in long-term stay institutions to contribute something to the cost of their bed and maintenance is constitutional.

This practice has existed for many years but the underlying legislation has been defective. Why the practice was allowed to continue in the light of such defective legislation is an important issue, and I welcome the speed with which the Tánaiste has moved to clarify this point. The report by Mr. Travers into this point will be published in the next few days and we will then be able to ascertain the reason this unsatisfactory position was allowed to continue for so long.

It is important to remember that this situation has existed for 30 years under 11 Governments of all political hues and nearly every party in this House was in Government at some stage during those 30 years. This report will clarify the reason that position existed. The openness of the Minister for Health and Children and the speed at which she has moved has displayed a welcome example of transparency.

It can never be correct to charge people for a service when the basis for that charge is defective in law. To do so to a group of people who are among the most vulnerable in society — the elderly and, in many cases, the infirm — is wrong and must not be allowed to occur again. Any such charges were deducted from the old age pension. That was, in many if not all cases, the only source of income for those elderly people. For many of the years during which the practice continued, the old age pension was at a derisory level and it was only in 1997, when the Fianna Fáil-Progressive Democrats Government came to power, that the old age pension started to attain a reasonable level.

The result of all of this is that many elderly people had no disposable income to spend on the essentials we all need such as toiletries, clothes etc. I know from attending long-term stay residences that the quality of their lives would have been intolerable had it not been for the generosity of their families and friends who spent their own money to give some dignity to their elderly relatives and neighbours. It is easy to forget today, when the old age pension is approximately €166 per week, how much more difficult it was to survive on a pension of £30 or £40 per week. I understand some health boards were in the habit of taking all the pension entitlements of people who were in long-stay accommodation. I welcome the speed at which the Government, in particular the Minister, moved to stop deductions as soon as it became apparent that there was a legal difficulty with these charges.

I ask that the Health Service Executive increase the number of people manning the information hotline, advertised in today's newspapers, because many of my constituents in Sligo-Leitrim are experiencing difficulties in obtaining information on the repayment scheme. There is a great deal of confusion among members of the public regarding when and how repayments will be made. The sooner this confusion is cleared up the better. The Supreme Court ruled that such charges are illegal under the existing legislation, and the sooner such moneys are repaid the better.

I wish now to deal with the second aspect of the Bill, namely, the introduction of doctor-only medical cards. As I stated on many occasions, despite the widespread and welcome growth in our economy in recent years, there are still people who find it increasingly difficult to access medical services, particularly those at primary or general practitioner level. This is especially true of those whose incomes just exceed the threshold relating to medical card qualification. In many instances, these people have families with three or four children. In the normal course of events, children succumb to the usual childhood illnesses such as upper respiratory tract infections. In many cases, these illnesses are self-limiting. Occasionally, however, they may progress to become more serious illnesses such as pneumonia.

I am aware of instances where parents delayed attending their GP in the hope that the ailment affecting their child might be self-limiting. Unfortunately, this has sometimes had disastrous consequences leading to patients requiring urgent admission to hospital. Cases such as those to which I refer came about purely as a result of patients' parents being unable to afford the cost of a visit to the doctor and not through any negligence on their part.

Inability to access medical care should not be allowed in any society. It is an affront to all standards of decency. I and my colleagues in Fianna Fáil have agitated for some time for an extension of the general medical service to cover an increased number of people. Some weeks before the recent budget, a formal motion I proposed was unanimously adopted at a meeting of the Fianna Fáil parliamentary party. I was delighted when the Minister for Finance announced the provision of the additional 200,000 medical cards on budget day.

The Bill provides the legislative basis for these welcome medical cards. Some members of the Opposition have tried to deride these cards. I have no doubt that the people who will benefit from the cards do not share that viewpoint because they will enable them to avail of medical care when they might otherwise, for the reasons outlined, be reluctant to do so. I understand that the additional funding of €60 million being provided in the current year will allow for approximately 200,000 of these cards to be issued and that it is the intention of the HSE to set the income threshold relating to the cards at approximately 25% above the existing level. These cards should be available next month. I urge the Health Service Executive to process applications for them as soon as possible. Any person who is just outside the current financial limit and who believes that he or she will come within the 25% range should apply immediately.

I commend this important and timely Bill to the House.

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