Michael Ring (Mayo, Fine Gael)

On a more serious note, this matter will become a big issue. It is already a big issue in Great Britain and it will also develop here. I have been saying for years that the additives being put into food are poisoning us. It is unnatural to see how long bread, milk and other foodstuffs last. It is not right. It is no wonder so many people are sick and dying from cancer.

In terms of the Bill, I wish to speak about medical cards and nursing homes. I will not repeat what I already said in the House in regard to nursing homes. What happened was a disgrace and should not have happened. I was junior spokesman on health in 2001 with Deputy Gay Mitchell when the Ombudsman clarified the rules and regulations on nursing home care. I raised the matter on many occasions. According to the Ombudsman, people were entitled to a State bed as long as they were aged over 70 and had a medical card. I used his ruling on every occasion when constituents came to me seeking a full-time bed in a nursing home in County Mayo. When doctors or health boards tried to put people out of hospitals I told them they had no right and I would take legal action against them if they did so. They never once removed anyone from a hospital because they knew the law and that they would not win in court. They knew they were obliged to find a bed for such people. That is a fact and it is on the record of the joint committee.

We had a great health board system but the only people it was good for were the people who worked for it. Another scandal is coming down the line in regard to people on pensions. The Minister of State may not be able to reply on the matter today but I intend to raise on the Adjournment shortly the new ruling by officials in the ambulance service. A woman from Ballycroy recently came to my clinic. She is over 70 years of age and is in very bad health. She needed a hospital appointment in Galway. She lives on about €165 a week. She could not get the health board to provide a service to bring her from Ballycroy to Galway, a 150 mile round trip. She could not afford a taxi and there was no family to help out. That is an abuse of the elderly. If the State wants her to stay in her own home to save it money, it should provide the few necessary services she needs, including home help and transport for her hospital appointments.

Why does the State have to make a big thing about nothing? I often wonder from where the people who make these decisions come. Perhaps they come from Russia in the bad old days. They have no conscience or understanding of the lives of elderly people. The Department should investigate why elderly people in Mayo whom I represent cannot be brought to badly needed hospital appointments. These people are prepared to stay in their own homes.

Reference has been made to home care and home help. Another issue, which I intend to raise first in a private capacity, is in respect of a family where an 18 year old is left looking after four children. I thought the State was there to provide services. I do not understand how the State or social workers could allow a young girl of 18 years of age to look after four children following the recent sudden death of her mother. I am investigating the case and intend to bring it to the attention of the health board and the media. It is not right and should not happen. The family gets one hour of home help every day. We would be better off providing home help and back-up for the family instead of having a social worker making a report once a week and then going home, which does not deal with the problems.

The courts recently made a decision that a young man would be sentenced to 18 months imprisonment. That person was advised by a professional that the best thing he could do at 16 years of age would be to pack his bags and go to England. It is sad if that is the kind of society in which we live. We have gone down the American road which is not a very good road to go down.

I intend asking the party spokesman to table two amendments in regard to medical cards. Health board chief executives always had discretion on this matter, and to be fair they used their discretion well. They must be allowed to have discretion to award a full medical card. If somebody has a medical card on medical grounds they should not be told from April on that they are not entitled to a full medical card, that they will be entitled to a GP-only medical card.

Yesterday, the Minister of State referred to the fact that local HSE areas will have an appeal mechanism. In my local health board area we had an independent appeal mechanism up to about two years ago. A barrister was employed by the health board as an independent assessor. I had many a row with him but in all fairness to him, 50% of appeals were successful. When he went into private practice and up to the Four Courts his replacement was a health board official who had worked with every single one of the community welfare officers. It would be impossible for such a person to make an independent judgment against his colleagues. I appeal to the Minister to change that aspect of the Bill. An independent person should fill that role, not somebody who worked for the health board for 25 years. Such a person would ring his or her colleagues to ask about the case and then say it is fine. I do not exaggerate when I say that 80% of appeals were unsuccessful as opposed to 50% when an independent appeals officer was in place.

I will ask the Fine Gael spokesman to table two amendments and ensure they are discussed and accepted. It makes sense that there would be an independent appeals officer and that people awarded medical cards on medical grounds or due to other circumstances would not just get the yellow pack type of medical card, but a full medical card. I ask the officials to take note of this to ensure it is brought to the attention of the Minister. It would be wrong if that happened.

The Minister referred to expanding the guidelines for medical cards. As they stand, the guidelines are ridiculous. A single person living alone in receipt of €153 does not qualify for a medical card according to the guidelines dated 1 January 2005. The threshold for a married couple is €222. If the couple have two dependent children under 16 years of age they get an allowance of €31 each for them. A family living on €280 or €290 is not entitled to a medical card. Even if one adds25%, it is still not enough.

I welcome any expansion of the entitlement criteria for medical cards, even GP-only medical cards. I have met parents who cannot bring their children to the doctor because it costs them €50. A consequent visit to the chemist could cost them €75. If there is a number of children in a house, nine times out of ten, sickness such as flu or another virus will spread to them all. I have seen many parents without medical cards who could not bring their children to the doctor because they could not afford to do so. Every person in this House knows the guidelines are wrong. The people who adjudicated on the guidelines for the past 20 years were the chief executives of health boards. How would they know, no more than some politicians, because they do not understand how this affects people? They were on big salaries and did not understand how the system worked.

I can table a parliamentary question to get information but I am sure the officials will have it. If one looks back over the past ten years at how the guidelines on income were increased, one will see that they did not even keep pace with inflation, which was low in recent years. It was wrong but it happened. They targeted the most vulnerable in society and took away their medical cards. This time next year when we return to the House, we will find that fewer people have medical cards than at present. With the minimum wage continually increasing, more people will fall outside the guidelines.

It is important to ensure community welfare officers or superintendents have the right of appeal and the right to grant full medical cards. I appeal to the Tánaiste and her Department to examine the proposal for an independent person to hear appeals rather than someone who worked for a health board for 20 years.

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