Mattie McGrath (Tipperary South, Independent) | Oireachtas source

No. My point is this is what happens in opposition and it touches on the issue of responsible Opposition and Government. While one might suggest that I am negative and oppose many things, I do not oppose this measure. I oppose many things the HSE does but in this case, I believe there must be a reason and it is necessary to cut our cloth according to our measure and, consequently, this issue must be examined. However, doing it in a knee-jerk fashion, as was done that time in the budget, caused holy war - if Members will pardon the pun - in that church that day. I never saw anything like it and it was quite frightening. People became animated and upset and much unnecessary anxiety was caused.

I acknowledge it was badly handled when the then Government announced people were obliged to give back the cards or they would be taken back. People who had them in their wallets took them out and showed them to me. They had these cards they had acquired from the State in their handbags and purses. These were people who were over 70, who had paid taxes and had worked in Ireland and elsewhere to build up their economies and had been given this gold-plated card, as they called it. Incidentally, I note the cards were even gold coloured.

They felt they had something, so where is the trust and the bond? It was simply announced as part of the Budget Statement that they would be taken from them. We calmed that situation down and produced new figures.

I still believe the threshold was quite high at €700 for a single person and €1,400 for a married couple, and I made that case at the time. I know many working men and women, with perhaps three or four children or even more, who have an income of half that amount of money. They might have nearly €400 in disposable income, but they cannot get a medical card. As everybody knows, children get sick and prescriptions are very expensive. There was a total imbalance. When we rowed back at that time under pressure we left the threshold too high. I will be criticised for saying that. There is no point in millionaires having a medical card. They do not need it.

The general practitioners, GPs, must take a share of the blame as well. I heard a GP speaking on the radio a couple of months ago about elements of the sick pay schemes. The GPs will have to pony up and level with people. They must tell them to stop coming into the surgery. I do not mean this badly but I know people who go to mass in the morning, call to their GP, go to the chemist, buy their few groceries and then go home. It is a type of social event. That is happening. They are lonely and isolated people. The doctors should tell them to call once a fortnight or once a month, unless they are sick. I have seen this happening. We all do when we are out canvassing. We call to the health centres and see what happens. I am not saying those people are doing anything wrong. They are entitled to do that, but what if they had to pay for it? When a child is sick, my wife will ring the doctor. She is a nurse, so she is better qualified than I am, but she will ring first because it costs €50 or €60 for a visit. Then one has to wait to see the doctor, which is the most ironic part. I have often rung on a Monday morning about a child who has been sick since Saturday or Sunday night only to be told to come in on the Tuesday morning at ten o'clock. In the meantime, one has a screaming child. That is the other aspect of this, when the doctor's office is full of people who do not need to be there. The GPs have a big role to play in this. With the roll-out of special centres for medical care, we will have to deal with this issue because it is unacceptable.

I have visited houses when canvassing, just as the Minister has. I have often been brought into a kitchen or parlour where press after press, even cabinets for good delph and china, are full of tablets. The tablets have been hoarded, unused, which is quite dangerous. They should have been returned to the GP for charities or to be sent abroad if they are still safe for use. They are dished out by the chemists when the Government is paying for them. We must examine this very carefully. We must be responsible about it but we must deal with it effectively. I am disappointed, as is always the case with the Department of Health and the HSE, that there is very poor consultation with the stakeholders.

Deputy Feighan commented about telephones and units. I was on the communications committee under the last Government. ComReg has failed to stop the ESB and Bord Gáis increasing charges. Each time they sought an increase the regulator allowed it. The savings should be made in that area. Deputy Feighan said that Eircom has announced a package for €19.99, but that is quite useless. It is only for a limited number of local calls. It is not the same as what people had previously. Those companies' representatives should be called before us. We are in a recession and we need them to decrease prices. However, every time they ask for an increase from the regulator, or the supposed regulator, they get it, regardless of the amount they seek. Bord Gáis has secured several increases in the past 15 or 18 months, as has the ESB monopoly.

Unfortunately, the same will happen with An Bord Uisce. As I have said previously, the only thing I like about that body is an t-ainm, An Bord Uisce. Úsáidim beagáinín Gaeilge agus tá Seachtain na Gaeilge ann anois. Aside from that it means less empowerment of the people. The Minister knows that as well as I do. He and I have been in council offices looking for water connections for people and support for the many group schemes that pioneered water projects, before the councils took them over. Many people have leakage problems and so forth and we are the go-between for them. Once responsibility is given to An Bord Uisce, it will be like what happened with the HSE. I am sorry but there will be no more accountability. Bord Gáis has handed over its own franchise for maintaining the gas service to Balfour Beatty. Now there are problems with staff and the companies. I do not mean to divert from the content of the Bill but that is a fact of life.

Bigger is not better. We saw what happened with Student Universal Support Ireland, SUSI, this year. It was an unholy mess. When one looks at how county councils and vocational education committees dealt with grant applications, one can see that the entire system went off on a tangent, and there was no accountability for it. There was also no understanding and, above all, no feelings for the people.

As previous speakers have said, people will get sick if they are cold in their houses, if they do not have security and if they are turning off security lights because of the cutback in the free scheme. We thought we had a land of plenty and that the pot would never run dry. However, it did and we must be responsible about it. Many of these people are very frugal and responsible. They might only have a single bar electric fire switched on. They do not waste. In fact, the schemes initiated by Sustainable Energy Authority of Ireland, SEAI, are helpful in those cases for saving energy. These people have worked and paid their way. They should not be penalised for that.

The history of the medical card for people over 70 is a mess. There is the cost of the medical cards for the over 70s and the type of medical cover provided. Many speakers have referred to private health care. I have a big family and the cost of mine is €6,000 per year, but it provides less and less cover. People are being forced out of private health care. As I said this morning in the House, people with mortgages are now being told by the bankers to get rid of their health insurance, their second car, their Sky subscription, which I do not have, and their broadband. What will they be left with? We must be careful. Then the health system is coming under more pressure because they are sick and going into hospital, thus clogging up the system.

There must be joined-up thinking here. While we must deal with the issue there must be consultations with the stakeholders. We must also have a tamer or more compassionate way of consulting and talking to people, rather than announcing this, that and the other and frightening them. That is what happened in 2009 with that announcement in the budget and all hell broke loose. Look at the anxiety that was caused. After criticising them a short while ago for a very valid reason, I salute the GPs for continuing to supply the drugs and continuing their visits in that interregnum when there was a great deal of anxiety.

We must deal with the drug companies. The pharmaceutical companies are among the best employers in Tipperary but we must deal with them effectively. We are only skirting around the edges and tickling them. There are vast profits in that sector and vast savings to be made. That is what we must attend to first. We must expose all the foreign trips by consultants and others promoting these drug companies. Half of that money should be kept at home. Cut the waste and give the services to the people.

The introduction of free GP care for all is another failed promise. It has been slowed down by huge problems. The introduction of universal health insurance is planned for 2016. The Minister says it will effectively end the two-tier health system. I do not think I or any of the other Members will be in the House when it happens. It is not going to happen. The financial situation will not allow it. It is imaginative and ambitious but there are too many vested interests. The biggest of them are the HSE and officialdom.

The Minister should cut out half of the baggage and red tape and deal with the issues effectively. He must deal with the drug companies, their prices and the prices and charges of consultants. What consultants are charging for any hospital procedure under the private health care system is just staggering. I recognise the good work that is done in hospitals but the charges are staggering. It is not a cash cow that can be milked over and over again. The game is over and the sooner people see that, the better.

Reform is required because the evidence is that user fees are a barrier to accessing care at primary care level, thereby causing late detection of illness, poorer health outcomes and greater pressures on acute hospital long-term care systems. The over-70s do not abuse the system and never have. They never had much, lived frugally, worked hard, educated their children, paid their taxes and are law abiding people. Age Action Ireland is one of the bigger representative groups. The HSE and several other Departments are funding many of those organisations. Look at the waste in that regard. Some of them have little to do. They set up offices with chief executives and a plethora of officials, but they are not serving on the ground.

I salute Muintir na Tíre. Why was it not consulted? It was founded by the late Canon Hayes in County Tipperary more than 50 years ago and does tremendous work.

I served on its board for a number of years. It works at the coalface with community alert and also did minor repair works and provided great value for money for people who received grants from the Sustainable Energy Authority of Ireland. During a blizzard two or three years ago, many of the organisations to which I referred, which had established helplines, were forced to refer callers to the Muintir na Tíre helpline because they did not have staff to deal with problems. Civil Defence, the Garda Síochána and many general practitioners dealt with problems whereas the organisations in question, despite being relatively large, placing major advertisements and offering free telephone numbers, could not tell people which towns and villages were in the county, not to mention providing any other information. Muintir na Tíre and community alert have 1,700 local organisations. I manned the former's helpline on the odd Saturday or Sunday for a short time and it was open for 24 hours per day. It was ironic that callers were referred to this helpline by other organisations which did not answer calls 24 hours per day. This is also the case in many other areas. For example, it is not possible to contact a social worker from Friday evening until Monday morning, other than in exceptional cases.

We must examine where the funding is going in some of the organisations that are always consulted. While they may have a large staff who enjoy good careers in a Dublin headquarters, they are not familiar with the facts on the ground, unlike Muintir na Tíre. As I stated, some of them were found out recently, which is no harm because they do not provide a service. While these lobbyists tend to be represented at various round table discussions, including national wage negotiations, because they can surf the Internet and know how to be in the right places, they are not delivering services on the ground. This issue must be examined to ensure money is allocated to the appropriate organisations. We must not continue to waste money in many areas.

On the revised income limits, I ask people to be practical and honest. Even in the rare cases where two parents are working, a family will find it difficult to survive on their take home pay after taxes, PRSI, pension levies and everything else have been deducted. They face significant costs if a family member becomes sick, and many parents will not visit a doctor because they want to save money for their children. That is the unfortunate reality. For this reason, everybody must share the load. I ask my colleagues to consider the proposal in a calm, cool and collected manner. It does not involve a massive reduction in thresholds and must be viewed in the context of the unholy mess created in 2009. Deputies should speak to community welfare officers because they know what is wrong in the system. Joined-up thinking is needed and efforts must be made to eliminate some of the scandalous abuses in the community welfare system. Any Deputy worth his or her salt will know what is taking place in his or her constituency because one can see prams that have been left outside health centres by people who have been given new ones. The Minister of State and I must buy prams for our children and pass them on. This is a racket involving reckless people and it should have been stopped long ago. Given the waste that is evident in many areas, the elderly must be the last people to be touched.

I thank Deputy Frank Feighan for raising the position of those who receive the Queen's shilling - I term I used earlier to describe another group - because they worked in England and receive a British pension. Two weeks ago, I listened to a discussion on a radio show. People rang up to say time was running out to submit applications for an entitlement in Britain because the closing date for receipt of applications was 31 March. People are not aware of this issue, especially older people. I do not mean to imply older people are illiterate but many need help filling out the relevant forms because they can be intimidating. I appeal to the Minister for Health to speak to his counterparts in the European Union to extend the deadline for the receipt of applications under the scheme to which Deputy Feighan referred. People are not aware of it and I must admit I first heard about it on the radio recently. The current pension arrangements between Ireland and the United Kingdom are reasonably effective.

Deputy Feighan also referred to turf cutting. I was not taking a snipe at him earlier but turf is not only a source of heat.

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