Michael Noonan (Limerick East, Fine Gael)

One category of people come to me quite regularly now lobbying against the change, which I ask the Minister to take into account. They are mostly women on State pensions who are widowed. They also have a social welfare pension — a widow's pension or survivor's pension. The combination of a teacher's, nurse's or garda's pension and a social welfare pension is driving them over the limit. There are other social welfare payments which also drive people over the limit in restricted circumstances, including carer's allowance etc. The Minister is exempting property from the means test. Somebody could have a house in Spain, a house in Kerry and a residence in Dublin. None of the residential property is taken into account. Yet if someone has a social welfare payment it is taken into account. The Minister would take much of the steam out of the opposition to the new measures if widows' pensions were not put into the calculation of the means test.

Across the public service €36,400 is above most pensions for public servants. Most such pensions are in the low €30,000s rather than in the high €30,000s and I can see why the Minister pitched it at that level. However, if they have any social welfare benefit — many of them have, particularly widowed persons — that is driving them over the limit and they are all losing their medical cards. I received a circular letter during the week signed by 65 retired teachers in Limerick. Approximately 60 of them were women who were widowed and they were all losing their medical cards. I would like the Minister to reconsider that. The savings have been whittled away to such an extent that she should address that aspect.

There is confusion in the Department of Health and Children about what constitutes a couple. The Nursing Homes Support Scheme Bill 2008 regards a couple as a married couple, a heterosexual couple living as a married couple or a homosexual couple living together. It does not include two siblings or any such arrangement. This Bill contains a different definition of a couple. It seems to be a heterosexual couple, a married couple or a couple living together as a married couple and there are other exclusions. The Bill should include siblings as well. More than anything else the Department should standardise its definition of a couple. It appears somewhat perverse that different legislation can come from the Department of Health and Children with different definitions of a couple.

The conditions for qualifying for a medical card under the Bill are threefold. First, a person must be over 70. Second, the person must qualify under the means test. Third a person must be ordinarily resident in the country. I have come across a group of people who have previously been caught out on social welfare payments and medical cards by the requirement to be ordinarily resident in the country. The category relates to missionaries. Priests, nuns and brothers who have been on missions for years are not ordinarily resident in the country. When they come home they cannot get medical cards because they are not ordinarily resident in the country. Many of them come home on an annual basis when they become elderly. They may be home for two or three months. Others take time out and might be home for a year or six months and then return. Nuns in particular return to their home convent. They might stay for a significant stretch of time and then go back out again. That category is disqualified. They have contributed considerably. I need not go into the detail — we all know the work to which they have dedicated their lives. I ask the Minister to draft an amendment to allow a waiver of the requirement to be ordinarily resident in the country for persons involved in missionary or charitable work abroad.

There is another category. Increasingly laypeople volunteer upon retirement to work with Trócaire or GOAL. I know of retired teachers, doctors and engineers who work in the underdeveloped world. They are not ordinarily resident in the country. They do not work for money. They would be disqualified under the provisions of the Bill. I ask the Minister to review the matter with a view to framing an amendment.

As mentioned by Deputy Reilly, the Minister should consider another area of the means test, which is medical expenses especially nursing home expenses. If one's total income is taken up by nursing home fees, that should not disqualify one from a medical card. We should also consider people who need to pay rent. Ordinarily people who fail the means test would have their own homes. However, for those paying rent, that rent should be taken into account as a reduction on the means.

I thank the Minister for her explanation. We are where we are and in the interest of trying to improve the mandate for the elderly I ask her to take some of my suggestions into account and table amendments.

See this speech in context