James Reilly (Dublin North, Fine Gael)

Many measures that will hurt the elderly were introduced in budget 2009. They will lose their medical cards. They will have to pay accident and emergency charges that have increased by €34 to €100 and public bed hospital charges that have increased by €9 to €75 a night. The cost of private beds in public hospitals has increased by 20%. The threshold for the drugs payment scheme has increased from €90 a month to €100 a month. Long-stay charges will increase by €33.25 a week for class 1 and by €24.95 a week for class 2. Health expenses relief, other than in respect of nursing home care, if we are to believe the Minister, has been reduced to the standard rate.

An article in today's The Irish Times mentions the case of a 77 year old woman who lives alone. When she suffered a stroke, she fell and broke her hip. She was brought straight to the accident and emergency department in her local hospital. If she did not have a medical card, she would have had to pay an accident and emergency charge of €100. She would have to pay €100 a month for her regular medication and she would have had to pay for her GP visits. The article estimates that when drugs refund scheme charges, physiotherapy and occupational therapy and follow-up GP visits are taken into account, the cost of the loss of a medical card to such a woman would have been €1,920. The elderly cannot afford to pay that much money. That is why they are so concerned about medical cards. Age Action Ireland and the Irish Senior Citizens Parliament are vehemently opposed to this proposal. I do not understand why we cannot show solidarity with them.

This measure is penny wise and pound foolish. A longitudinal study that was conducted by St. James's Hospital shows clearly that the introduction of universal medical card access for people over the age of 70 led to reductions in strokes, heart attacks and rates of hospitalisation. It brought about a considerable saving to the State and a considerable social gain for elderly patients. The word "hypocrisy" was mentioned earlier. I suggest that it is hypocritical to say one thing and do something else. I ask Deputy Treacy to bear in mind that hypocrisy does not involve changing one's mind on the basis of new information, which is what evidence-based professionals are prepared to do.

According to figures published by the CSO, people over the age of 70 visit the doctor 5.2 times per annum. However, a recent study conducted by one of the largest general practices in the country found that people over the age of 70 visited the practice 11.1 times per annum. The increase in visits has resulted from the availability of medical cards. We need to monitor illness, which is more frequent and prevalent among the elderly. We need to prevent the complications that tend to land elderly people in hospital. We should not put a block, in the form of expense, between people and their GPs.

I would like to ask the Minister about the issue of nutritional supplements, which is being studied at present by a group led by Dr. Michael Barry. I hope the group will understand the value of these medicines. I refer, for example, to the fact that they are of great benefit to people who are elderly, malnourished or terminally ill, such as people with chronic illnesses who cannot absorb their food properly. Many studies have pointed to the glaring fact that malnourished people have much worse outcomes when they undergo surgery, particularly major surgery, than those who are properly nourished when they go under an anaesthetic. That is hugely important. I hope the focus will not be on saving money yet again, rather than on clinical benefit to patients. Section 7 of this legislation provides that current medical card holders who are over the age of 70 will have to make a declaration to the HSE by 2 March 2009. As I mentioned earlier, the Bill does not appear to accommodate those who might have difficulty making such a declaration.

I have already referred to the issue of universality. Many people are concerned that this measure represents the first step in the removal of the universal principle. They believe it will be followed by the abolition of universality in respect of the electricity allowance, the natural gas allowance, the electricity group account allowance, the bottled gas refill allowance, the telephone allowance and the free television allowance. People look forward to being able to avail of such allowances, having worked hard all their lives, when they pass the age of 70. They want to plan for the future without having to worry about expenses of this nature. Many people have told me they would give up their second pension rather than lose their medical card. This has been said publicly. That is how important the medical card is to them. They are keen to enjoy the comfort and safety of knowing they will be looked after, without money being an issue, if they get sick.

A major upset to the elderly of Ireland has been caused for the sake of €16 million. The former Deputy, Joe Higgins, used to complain that the former Taoiseach, Deputy Bertie Ahern, had stolen his clothes. It seems that Deputy Ahern took those clothes with him when he left office. He has left Fianna Fáil naked and bereft of any social conscience. It is clear that the Government has lost its compassion for the people. If that were not the case, it would not have instituted this attack on the elderly. What other conclusion can one draw? What party with a social conscience would rob the medical card from the elderly, cut tax relief on nursing home fees and increase VHI premiums? I ask the Minister to reverse this measure.

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