Bernard Durkan (Kildare North, Fine Gael)

I welcome the opportunity to speak on this legislation, which has been much talked about. As the last speaker said it has been ongoing for the last 30 years and has been dealt with by different Ministers, civil servants and health boards. I was a member of a health board in the 1970s, 1980s and part of the 1990s when this was discussed at health board meetings. I recall the views expressed and it is interesting to look back. Some people who had worked hard all their lives, striven to rear their families, fought hard to eke out an existence in this and other countries, survived high interest rates and illness and suffered much adversity over the years, were referred to an institution when they are no longer able to fend for themselves at the end of their days. There are situations due to the absence of family or different work patterns in which that is the only way they can be accommodated. An interesting debate used to take place when interest rates were in the early 20s that it would be unfair to expect the State to look after people in these situations and that there should be a payment. I have no problem with the payment but the underlying logic was that as long as a person had a house it should be sold and the person's assets liquidated to pay for his or her maintenance in an institution. I often thought how callous and thoughtless people can be. Did they not realise that the day may come when they will find themselves in that situation? Oddly, some of the people who expounded that theory were older then than I am now. I could not understand how thoughtless people were to think that those people, who had worked through hard times and survived should pay the ultimate price by having their houses taken. There were circumstances in which the house was sold over people's heads to pay for their maintenance in an institution. That is a sad reflection on our society then and now.

People have spoken on the merits of the Celtic tiger and it is great to know we are among the richest nations. By our deeds we will be judged. When people come to judge us and write about us the way we treat the less well off in our society, our children and our elderly will be the basis on which they will come to their conclusions.

Deputy Healy said the payments were illegal. They were not, but no legislation had been provided to facilitate the making of charges. It was identified in the 1980s but nobody had the guts to introduce reasonable legislation. Everybody saw the opportunity to make more money from the system. Let us examine what is happening. I am dealing with a mother and daughter who jointly own the family home. The mother, by virtue of the nature of her illness, is in a nursing home. The subvention for which she qualifies is the paltry sum of €34 per week whereas the weekly charge is €900. The daughter, who is still at work and is the joint owner of the home, has been told that her mother's half of the home must be liquidated and the payments put towards maintenance before any change will take place. That is a disgrace.

The bureaucrats who work in the system and who come up with such conclusions and make such decisions should think about their own day, because their own day will come and it will be a sad day if they are treated in such a callous fashion. During the 1980s a senior official in the health services fell into serious bad health and was hospitalised over a period of years. He found himself and his family almost destitute as a result of paying health bills. The wise will tell me that he should have had health insurance. He had insurance but after a certain period of serious bad health that insurance was no longer economical. The wife of the unfortunate man wrote to me to explain the family position to the effect that the family home had been sold and the next stage was the decision whether he would be discharged into private rented accommodation for the short time he still had left to live.

Imagine treating a person who had worked in the health services in that fashion. Whatever we might be called — Celtic tigers or otherwise — we have much to answer for in the context of how we have treated some people in this time of wealth and affluence in this so-called caring society, with its aura of how good, giving and caring we are. We have a lot to learn.

I welcome the Bill in so far as it deals with the situation. However, if it does not deal with the type of situation to which I have just referred and if reason does not prevail with those who are given the job of making decisions, we are wasting our time. As Deputy Crawford stated, it would be best if the same time and energy were given to medical examinations and accident and emergency services, and the same emphasis were placed on prescribing and on medical cards, as is placed on the interrogation of those who are deemed to qualify or not for an entitlement. It is crazy that we should be impervious to what is going on. We hear daily of the billions of euro that are being spent in the health services but we do not seem to consider carefully where and how they are spent.

In recent years I dealt with the case of a constituent who had a serious illness which turned out to be terminal. He was living in conditions which were not ideal and did not have any institutional help. Eventually, he managed to get limited home help but he was then forced to look for an institution that would cater for a person in his situation. This patient required 24-hour, heavy, ongoing nursing care. It took me three weeks of a continuous barrage of telephone calls, letters, parliamentary questions, repeat telephone calls and so on before I eventually had to identify a particular ambulance driver and the personnel involved to chaperone the person into an institution where, unfortunately and due in no way to the excellent care he received, he passed away. If all the time and energy spent in attempting to get accommodation and treatment for the unfortunate man had been devoted to providing the treatment, it would have been much easier and cheaper for all.

We are reaching a situation where there are so many preventative barriers to the achievement of the entitlements of various categories of people, especially the ill and elderly, that it is no longer possible to access these entitlements. Many people throw up their hands and decide it is not worth trying and that they will not humiliate themselves by going any further down that route. I know of a family where the father and mother both required care and attention. As no family member was at home or nearby and in a position to provide that care, the parents were lucky enough to get into a nursing home, which cost approximately €1,000 per week. No subvention or other payment was received because the unfortunate people owned their house. That is the sad penalty. They owned their home and it was deemed that it should be liquidated to pay for their upkeep. The husband of the couple passed away and, eventually, the wife was referred to the same institution. It is a repetition of the same old story. I could paper the walls with the letters that went backwards and forwards in that regard.

Decisions were made regularly which we knew had no basis in law. Even with the passage of this Bill, I do not know where we will be in a few years because I cannot be sure the situation will change and cannot foresee how it will change. If we are to have the same interrogation and the same treatment of elderly people whose only option is institutional care, then we will not make progress and the degree to which we pride ourselves on our caring society will not add up.

Deputy Gogarty reminded me that last week one of the Government parties came out with a unique proposal, which it has not yet achieved but which it obviously intends to carry out, to abolish taxation and provide services. I know there are experts, financial and otherwise, in this House, the country and worldwide but I am sorry to have to suggest that in most democracies attempts to achieve this have failed so far. I presume if we re-examined the theory of gravity and the case of the falling apple, we could qualify the theory in various ways and perhaps disprove it. However, I am interested to know how one part of the Government, the lower end, will prove that it will deliver health and other services with virtually no taxation.

If that party is still around at the following general election, it will abolish taxation entirely and pay a premium to the people of the country by and large. Is that not the obvious direction to go? Why not do it?

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