Joe Callanan (Galway East, Fianna Fail)

I support the Bill which provides for the introduction of doctor-only medical cards and the making of small deductions from the old age pensions of people in welfare homes.

I congratulate the Tánaiste on the introduction of doctor-only medical cards for people on incomes above the full medical card thresholds. The cards will facilitate free doctor visits for a significant number of families on low to medium incomes. The families will also be able to obtain free drugs above the €85 per month, or approximately €21 per week, threshold of the drugs refund scheme. Doctor-only medical cards are an aspect of a great scheme which is demonstrative of the way the Government looks after the less well-off who find it difficult to meet the cost of doctor visits.

I welcome the increase in the income thresholds for ordinary medical cards which will extend eligibility to a greater number of people. I ask the Tánaiste to examine the possibility of providing medical cards to all students. As she knows, students do not have much money in their pockets and doctor visits may prove costly for them. The former provision of medical cards to all students was discontinued by a Labour Party Minister.

I compliment the welfare homes in my area of east Galway on the excellent care they provide to patients. The Tánaiste visited St. Brendan's Home in Loughrea where she saw at first hand the quality of care provided. She witnessed the home's problematic upstairs accommodation and promised to give a high priority to the provision at the home of the very necessary 60-bed unit to relieve the dangerous conditions for parents who must stay at the building. The 60-bed unit and the community welfare home at Ballinasloe formed part of the national development plan and the plan for the former Western Health Board area. Ballinasloe has been promised a community welfare home for 20 years. Will the Tánaiste approve the projects to proceed? There is strong demand in Tuam for the provision of a community hospital. I recognise that the Tánaiste is considering various ways to provide it as a step-down facility to relieve the great pressure on Galway's two city hospitals.

A few night's ago, I attended a meeting of nursing home owners concerned at the level of subvention paid in the HSE's western area as against the level paid in the east coast area. A subvention of only €228 is paid in the west as opposed to €520 on the east coast. It is unfair as there is little difference between costs in each area. Will the Tánaiste consider the matter as some of the smaller nursing homes in the west find it very difficult to survive? I am strongly of the opinion that home-based subventions should be introduced to give elderly people the choice to remain in their homes for as long as possible. Given the choice, most elderly people would prefer to be cared for at home.

While I accept that changes in income disregards for carer's allowance have been of great help and I thank the Minister for Social and Family Affairs, Deputy Brennan, for them, many elderly people are not connected to a person eligible for the allowance to care for them. If such elderly persons were provided with home-based subvention, they could pay for the care to allow them to remain at home for as long as possible.

Social services do great work in caring for the elderly which is not properly recognised. In most cases, it is the work of social services which allows elderly people to remain at home through the provision of meals on wheels to remote areas and transport to centres for the elderly at which people can enjoy a hot meal and the company of friends in a social setting. Much of the work is carried out voluntarily. I acknowledge the work that is done for the elderly and call on the Tánaiste to provide as much funding as possible to social services. Last year, the then Minister, Deputy Martin, provided a new minibus for Portumna social services to transport older people from remote areas to centres for the elderly. It was a great addition to system. Under the direction of Sr. Alacoque, Ballinasloe social services make a significant contribution in my local area. I acknowledge also the great work being carried out by public health nurses who must provide services of all sorts when they visit patients. They are well able to do their jobs.

I ask the Tánaiste to clarify the position on refunds of charges for nursing home care for pensioners with medical cards who are or were in private nursing homes. Are they entitled to a refund? I take the opportunity to acknowledge the work of the previous Minister, Deputy Martin, for the health service. I voice my support for the Tánaiste in her efforts to provide quality health services for young and old. While it is a difficult task, a good woman, born in Ballinasloe, is well able for the challenge.

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