Seymour Crawford (Cavan-Monaghan, Fine Gael)

I thank the Ceann Comhairle for allowing me the opportunity to raise the important issue of funding for the Health Service Executive, HSE, in the north east.

The population of counties Cavan, Monaghan, Louth and Meath, in what was then the north-eastern health board region, has increased more than in any other region between 1971 and 2002. The most recent figures available show that between 1996 and 2002 there was an increase of 12.7% as against an 8% rise in the overall population. From 1971 to 2002 the population increased from 250,000 to almost 345,000 in the north-east region and that trend has continued at a significant rate to date.

Unfortunately funding for health services in the north east, even this year under the new HSE, has not taken into account the massive population increase. The most dramatic increase is in the 25 to 44 year age group. There is also a massive increase in the number of persons aged 65 years and over, many whom have to be dealt with by the HSE through home help or home care and nursing home structures with the support of subvention. The demand for the services provided by the HSE continues but unfortunately funding does not match. Funding is based on the funds supplied when the health boards were established in 1971. It was not adjusted to take account of the massive increases in population in the region. Having raised the issue before, I appreciate arguments will be made that the north east benefits from the services provided by hospitals in the Dublin region. However, the same can be argued regarding the midlands, the west or any other region.

My problem and that of the people I represent is that we find out the services available in other areas are completely different. For instance, only recently I came across a seriously handicapped person having to use a wheelchair. She had lived in Donegal were she was receiving 12 hours home care per week, yet because her husband's involvement brought him to Monaghan she now receives only two hours.

In another case I dealt with, a constituent from Cavan-Monaghan was put into full-time care in the western region to be near some of her family members. However, the owner of the home could not believe the difficulties he had in getting the subvention agreed initially and then getting payment of that subvention from the time the person entered the nursing home. He told me that there would not be the same financial pressure in his region.

Another issue of serious concern is the fact that almost 10,000 people in the constituency of Cavan-Monaghan have lost their medical cards since 1997. That figure is out of a population of 109,000 people with an average income, according to Government statistics, of approximately €14,500. By comparison, only 8,000 people lost medical cards in the county and city of Cork, with a population of 550,000, although the figures suggest the average income there is around €16,000.

Out of a national population of 4 million, 100,000 medical cards were lost. This clearly shows a totally unacceptable and uneven distribution of access to free medical care, with Cavan-Monaghan at a serious loss. This loss was even more clearly highlighted to Oireachtas Members from Monaghan who, with the deputation from the VEC, met the Minister for Education and Science, Deputy Hanafin. They were advised that the only reason Ballybay College in County Monaghan was not classified as disadvantaged was the fact that parents of the children did not have medical cards. That means they would have to pay for bus services, if such were made available. In addition, they do not benefit from the free book scheme or the back to school clothing allowance.

This is the reason I am not just asking but begging the Minister and the Health Service Executive to treat the people of the north east on equal terms, like everyone else, for funding. They are not seeking better terms or asking for any advantage. Wherever they live, elderly persons should have the same services available to them. A low-income couple with a young family should have the same right to a medical card as those elsewhere. I urge the Minister to ensure that a per capita sum is made available nationally, rather than being based on some historical and irrelevant numbers that bear no relation to the current situation.

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