Séamus Healy (Tipperary South, Independent)

I am delighted to have the opportunity to speak on the Bill. This problem has existed since the early 1970s and it has been a shambles since then. Almost every political party in this House has been in power and had responsibility for the Department of Health and Children in that time. Since the late 1980s, the political establishment and the Department were aware that the system for charging patients in long-stay institutions was illegal, yet they did nothing about it. Different Ministers from different parties were in charge of the Department, knew this system was illegal and refused to do anything about it. That is a scandal and it will be written about in the years to come because there is adequate information in this story for a bestseller. To add insult to injury, the current Minister brought in a Bill that was deemed unconstitutional. Now we must deal with this Bill.

It is time that politicians, especially those who worked in the Department over those years, admit that they have a political responsibility for what happened. They should not try to pass the buck to someone else, be it a civil servant or a Minister of State. The buck stops with the political head of the Department of Health and Children. Every party had members in that Department, they were aware that these charges were illegal, yet they refused to do anything about it. It will go down as a lesson to be learned in the political history of this country.

I am astonished by the proposal that some outside agency will arrange for the repayment of these charges at a horrendous cost. A huge amount of resources and public money have already been wasted by this Government on PPARS and €1 million per year is spent on securing and storing the voting machines bought by the former Minister for the Environment, Heritage and Local Government, Deputy Cullen, even though they will never be used. It is now proposed to spend somewhere between €20 million and €50 million — nobody knows the correct figure — on making these repayments. There is adequate expertise in the public service. The Departments of Health and Children and Social and Family Affairs, the HSE and the Revenue Commissioners all have experience in repayment schemes and the knowledge required to do a good job. Once a template is put in place for a scheme of repayments, the process becomes routine. It is a scandal to suggest that we should waste further public money. I would have thought that publicity over the waste of public money would have brought some people to their senses but that obviously has not happened.

The people who were effectively robbed by successive Governments and Ministers for Health created today's Celtic tiger. They worked hard and paid their taxes while others ripped off the country. However, they now find themselves being ripped off in their old age. There is no doubt that the 1916 leaders we have been celebrating, such as Pearse and Connolly, who spoke about cherishing all the children of the nation equally, would turn in their graves if they knew of this saga or of the way in which the public has been ripped off. PAYE workers have paid more than their fair share but a golden circle of people in politics and business ripped off the country in the latter half of the 20th century.

If we are to resolve this problem, we should address it in its entirety. The Tánaiste and the junior ministers at the Department of Health and Children and the HSE know full well that this Bill only deals with half of the problem and that thousands more elderly people have been forced into private nursing homes. Medical card holders who have requested beds in public institutions have been denied the medical services to which they are entitled. Some years ago, the Ombudsman clearly indicated that this was also illegal and I believe that the Tánaiste and her Department should address that matter in this legislation.

Nearly 500,000 people over the age of 65 live in this State, the vast majority of whom can look after themselves or be looked after at home. They do not want to stay in nursing homes or public beds but would prefer to see out their days at home in the company of their families and communities. Between the 1970s and 1980s, when I worked in the health service, and today, much attention has focussed on the provision of community care services. However, the substantial initial costs of providing these services are not being met, even though the investment could bring significant returns.

Home help services have, in effect, been reduced in recent years. The maximum home help available to any individual in my area and, I am told, elsewhere in the country, is about one hour per day excluding Saturdays and Sundays, when no help is available. Anyone who believes that people can be looked after at home in their communities on the basis of a diminishing home help service does not live in the real world. Elderly people who come out of hospital and live alone receive one hour per day of help. That level of assistance probably lasts for one month, after which it is further reduced to two or three hours per week at most. Home help services are the key to ensuring that elderly people are able to look after themselves or be looked after at home in their own communities, which in turn would create significant financial savings for the State. However, the will does not exist to provide proper community care services. The laundry and chiropody services which should be provided in the community are non-existent.

If elderly people are to remain at home, the way in which carers are supported is vital. Despite improvements in past years, carers have not been properly resourced. The means testing of the carer's allowance is particularly unhelpful in looking after people at home. The fact the carer's allowance will not be paid in addition to the carer's basic social welfare payment means that, for example, a person who is dependent on a spouse's payments gets a carer's allowance of €180 but loses the €120 adult dependent allowance. This amounts to a small payment for caring 24 hours a day, seven days a week, 365 days a year.

There should be significant changes to the carer's allowance. It should not be means tested and should be payable in addition to social welfare payments. Further publicly funded elderly beds are necessary too. St. Patrick's Hospital in Cashel, which is in my constituency, is a geriatric hospital that provides a fine service. One of its wards, St. Michael's, has the capacity to provide a further 30 elderly beds at a cost of €1 million. The waiting list for that hospital is 176, which means people must wait at least two and a half years for admission. Many on that waiting list will not be alive when they are called. The hospital staff frequently contact relatives of a person on the waiting list only to find the person has died. If we could provide another 30 beds at a minimal cost that situation would be alleviated.

I wish to address funding. People will say my suggestions will cost a fortune. They will cost money, but this country is awash with money. There was a €6.7 billion revenue surplus last year and since this Government came to power in 1997 there was a revenue surplus of €39.6 billion. That surplus should be used to provide human services such as health, education, housing and additional gardaí, particularly for community and drug policing. Most of that money is being used to provide roads, bridges and broadband. This is poor economics as everybody knows that capital projects in most, if not all, European countries are, and should be, funded by borrowing. I can hear somebody saying we almost bankrupted the country before by borrowing. However within EU rules we can borrow up to an additional €4 billion a year. When the country was nearly bankrupted before it was due to borrowing for day-to-day expenditure by a previous Fianna Fáil Government.

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