Beverley Flynn (Mayo, Independent)

I wish to raise an issue that has been raised many times by people on all sides of the House. I do so because of the decision by the Health Service Executive in County Mayo not to pay any more enhanced subventions for new applicants. The HSE has increased its subvention payments in the south and east to approximately €750 per week. This situation has arisen despite the fact that the Tánaiste last year gave an undertaking at a meeting of the Oireachtas Committee on Health and Children that she would bring about equality of subvention rates across the country, that she recognised discrimination existed and would do something about it. In April 2005 the enhanced subvention rate in County Mayo was €200, while in the east of the country it was €600 per week. In February 2006 it was €310 per week in Mayo and €720 in Dublin. Today it is €310 per week in Mayo while it is €750 in Dublin. Despite the Tánaiste's assurances, over the past year we have seen the gap widen between subvention rates in County Mayo and County Dublin.

I am particularly disappointed that the HSE in County Mayo has decided that no new applicants will get enhanced subvention, which means the most a maximum dependency person can get, based on the means test, is €190 per week. This is having a serious effect on the situation in our accident and emergency departments. If we are serious about tackling that problem, this is one of the critical areas in which we can do so. The Tánaiste agreed that it is discriminatory and made a commitment to do something about it.

I will anticipate the Minister's reply, as there have been many similar replies on this matter. I do not want to know that it is a means-tested payment. I know that. I do not want to know the subventions available to medium, high or maximum dependency people. I have that information. Neither do I want to know that €140 million was spent on subventions in 2005. I do not want to know that €20 million was allocated in the budget to deal with subventions and to bring about equality because, as I have already stated, that €20 million is already spent and has made no difference. We have moved backwards from the position last December when the €20 million was allocated. Finally, I do not want to know that a working group in the Department is working on the question of how to deal with long-term care because I am aware of that.

Having been a member of the Oireachtas Committee on Health and Children for a number of years, I am aware that there have been many positive developments in long-term care, particularly home-care packages, of which 500 were announced last year. These allow people to be looked after at home rather than put into a nursing home. I support this excellent Government policy. However, of the 500, five were made available in County Mayo. Some 3,000 are to be made available in 2006 and Professor Brendan Drumm has promised that we will get more of them. However, as the Minister can see, they are not a real alternative.

The only way this situation will be tackled and genuine equality achieved across the country is by putting serious money into the system so that people in County Mayo do not receive €190 per week while a person in Dublin gets €750. The Minister may argue that nursing home charges are more expensive in the city and that is true, but not to that extent. This issue must be tackled. On one occasion last month there were 30 people on accident and emergency trolleys in my county. There is no reason for people to be on trolleys. Despite the ten-point plan implemented last year, no contract bed was awarded to Mayo General Hospital.

I ask the Minister to throw away the script that has probably been prepared for him mentioning all the items I have listed, and to tell me what the Government will do to honour the commitment given in the budget and in the committee last year. I hope it can be honoured. Many people who operate excellent nursing homes in the west of Ireland find it difficult to survive and, sadly, many patients take up acute beds in hospitals. Although these people should not be in hospital and are more suited to a nursing home, they and their families cannot afford to pay the difference between €190 and the nursing home charge, which is probably in the range of €600 per week.

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