James Reilly (Dublin North, Fine Gael)

Yesterday, at a press conference, the Minister for Health and Children mentioned that people over the age of 70 visit the doctor four times a year, on average. I cannot find any evidence to support this proposition. I do not know how the Minister, Deputy Harney, gets her figures. My figures indicate that people over the age of 70 tend to visit the doctor between ten and 12 times a year. Will the means test for the revised medical card scheme be index linked? Will people continue to haemorrhage out of the scheme as they have in past years? The scheme is not keeping pace with the cost of living. It is important to reiterate that 139,000 people over the age of 70 currently have a medical card that is not means tested. The Government's proposal will reduce that number to 14,000. Some 125,000 people, or 90% of the total, will lose their entitlement to a medical card. The Minister told us yesterday that the average cost to the State of an over-70s medical card, when doctors' fees and drugs etc., are taken into account, is €1,650. That is the cost of a whole year's care and drugs. It is also the cost of a single night in hospital. The Government is penny wise and pound foolish. This cut is all the more savage because it is at the expense of the elderly.

I read an article written by a young lady, Ms Orla Tinsey, in yesterday's Irish Times. Ms Tinsey believed the Minister for Health and Children when she said that isolation rooms would be provided at St. Vincent's Hospital and that a new cystic fibrosis unit would be brought into operation. Ms Tinsey is in a ward with many other sick people, as a result of the Minister's breach of her promise, so she is open to all sorts of infection. I have mentioned previously that the HSE takes home care packages from disabled children. I will not go back over that ground. The Minister told us yesterday that pensioners will lose their medical cards from 1 January. The HSE intends to write to 139,000 pensioners to invite them to send details of their income to that organisation. I wonder when the excess managers in the HSE will receive letters inviting them to avail of redundancy packages. There was no clarity on this issue yesterday because the Government's focus is on the soft option of hitting the elderly, rather than tackling the real problem of the bungling bureaucracy known as the HSE.

The office has been inundated today with calls from people in all parts of the country. I will mention one case, that of a 72 year old former civil servant with pulmonary fibrosis who has three years to live. He asked me to mention his name in this Chamber, but I will not do so. He was crying as he told me he wants to enjoy the three years he has left. He is already paying €200 a month for medication that is not covered by the medical card because it is experimental. He will now have to pay an additional €100 a month for medication and a further sum for doctors' fees. Am I supposed to tell the man in question, who is at the end of his tether, that he should be patriotic? This outrageous attack on the elderly will be remembered for a long time. Despite the weasel words to the contrary that we have heard from the Minister, Deputy Harney, and the Taoiseach, I do not doubt that this budget will go down in the annals as one that hurt the most vulnerable people in our society.

The more we examine this budget, the more examples of cynicism we see. Some €10 million has been provided for mental health services. What happened to the €50 million that was promised for such services in A Vision for Change? A further €10 million has been provided for disability services. How far will that go? People with disabilities who are under the age of 18 will now be eligible for domiciliary care allowance, rather than disability allowance. How more cynical can one be? Such people will get just €350 a month under the domiciliary care allowance, whereas they were getting €200 a week under the disability allowance. The families of disabled children will lose €450 a month as a result of this change. Some 125,000 pensioners will now have to pay the health levy. An unexpected consequence of the introduction of the medical card scheme was that such people did not have to pay the health levy, but they will now have to do so. Given that we were told at the time that the cost of the scheme to the Exchequer would be €200 million, how much will this measure cost the elderly now?

The threshold for the drugs payment scheme is to be increased from €90 to €100. The 1.6 million people who are registered under the scheme will be affected by this measure. A new €400 grant has been established as a sop to people over 70 years of age. This proposal mirrors one of the failed policies of the neo-conservative Bush Administration. If people are given inadequate resources, they will be forced to ration their health care services. It is despicable. The €3.5 million that was allocated by the Minister in the 2007 budget for the development of 1,100 day care places was not spent for that purpose. Some €0.5 million has gone missing from the fund. The same thing can be said of home help hours and home care packages. Some 250 paramedical and other allied professionals were supposed to have been recruited in 2007, but that did not happen. The €2.5 million that was allocated for the meals on wheels service in 2006 was not spent on that service. It was used to provide other services to older people. Six elder abuse officer posts remain vacant, despite the fact that money was allocated for them in 2006. It is obvious that the HSE is not serious about dealing with elder abuse.

Some €20 million was assigned to fast-track 860 public long-stay nursing home beds, but just 188 beds have been provided under the scheme. The accident and emergency charge has increased from €66 to €100. Private bed costs have increased by 20% in our public hospitals, with a consequent impact on private health insurance. As many of this country's amputees are over the age of 70, they will be affected by the change in medical card eligibility. They will now have to pay the full cost of their appliances. It will bring more hardship on those least able to deal with it. Has the Minister considered the contractual issues? I refer to patients, rather than to doctors. Many people over the age of 70 have medical cards which say "valid until 2011". They have planned their finances on the basis of having a medical card. There will be legal issues in that regard. In its search for a quick fix, the Government has gone for the poorly thought-out soft option. How can people get back into the VHI system? People who have stopped their VHI payments will have to wait for five or ten years before they can make a claim in respect of a previous illness. What good is that to a man in his mid-70s or 80s? It is no use. Has the Government index linked the means test?

It is clear that Fianna Fáil has forgotten its slogan of some years ago, suggesting that health cuts hurt the old, the sick and the poor. It is noteworthy that the only group to have welcomed this budget is the Construction Industry Federation, led by the Minister for Health and Children's old buddy, Tom Parlon. Families will reflect on this budget as the full extent of the Government's ineptitude dawns slowly on them. College fees — let us call them what they are — are back. Transport costs are increasing. Irish taxpayers are the only people in western Europe who have to pay tax on tax. The Lenihan levy taxes one on one's entire income, even though one has already paid tax on it. It is actually a 3% tax on one's tax, which is extraordinary. We should not muddy the waters by referring to €400 payments — it is clear that 125,000 elderly people who will lose their medical cards.

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