Dara Calleary (Mayo, Fianna Fail) | Oireachtas source

On many occasions in this House I have railed against what I call the notion of silo government where Departments take decisions without any co-ordination or consultation with other Departments and one sector or community invariably gets overly impacted. The evidence is there that this is what has happened on this occasion. The Department of Health decided to go after medical cards. The Department of Finance decided to cut the tax relief on health insurance. The Department of Social Protection decided that the telephone allowance and the bereavement grant were within its sights but it seems that nobody in the three Departments spoke to each other to try to assess if this would impact on one particular group in society or the other. That is what has happened.

If we are to look at the reports on the lead-in to the budget, which I notice have not been denied, the Minister, Deputy Reilly, was the last man to go into the Department of Public Expenditure and Reform to present and seek support for his budget. Other Ministers had done it. He was the last man to do so and he presented an unachievable budget to the Minister, Deputy Howlin.

That then forced the Minister for Public Expenditure and Reform, Deputy Howlin, to take control of the Minister for Health's Department and its expenditure. What we now have is a collection of departmental initiatives which are impacting in a very severe way on older people, in particular.

I heard phrases such as "scare-mongering" and "communications problems" used tonight. If there is scare-mongering and if there are communications problems, I invite anyone to come to my office to see the real cases with review letters from the Department of Health which I have dealt with, and not only since the budget. This has been going on all year, that is, the reduction in the number of medical cards and the changing conditions. Even the Minister admitted he was not aware that the qualifying provisions for medical cards had changed, so it is no wonder we are slightly wary about his ability to perform in his own Department. Those on the Government side cannot accuse the Opposition of communications problems and stoking fear when the figure of €133 million is put beside a very vague issue of medical card probity. That is not communications in terms of how one presents a measure. The Government keeps saying many people have gone away and have died but that is not correct. It states 35,000 medical cards will be taken from the over 70s or will be switched to GP cards. That is the figure when one calculates the saving in the budget documents. Either the figure put down as savings is wrong or it is right. Perhaps the Minister of State, Deputy White, will clarify that.

On budget day the Minister for Finance said the change to tax relief for health insurance policies would only affect gold plated policies, which the Taoiseach repeated on Leaders' Questions this morning. The difficulty is that as people get older or as they develop a medical conditions - many young people are in that situation - their health insurance gets more expensive. It is not gold plated to have basic cancer treatment covered by Vhi or Aviva. If one suffers from chronic pain syndrome and must travel to Dublin every six weeks to have one's pain pump filled, which gives one relief and allows one to live one's life, it is not gold plated to have a Vhi policy costing €3,000 per year minimum. The Department has not come up with an alternative figure to that suggested by the insurance companies that 70% of policies will be affected. Older people will bear the brunt of that change to tax relief for health insurance.

The big problem with medical cards is the number of people whose cards have been reviewed unbeknown to them. They have medical cards with expiry dates next year but when they go to the doctor, he or she informs them the card has been changed. The doctor can no longer treat them because he or she has been told by the Department the medical card has been discontinued, or will not be renewed, before the patient has been told. It is not the fault of the people in Finglas, who are doing a very good job in difficult circumstances. It is due to a complete lack of centralised policy at the top of the Department and seeing medical cards as an easy fix when it is panicking to get a budget figure. That seems to be what is happening, if we are to believe all the stories from Fine Gael about the Minister's activities in the days before the budget. Unfortunately, the people paying the price are medical card holders and people over 70 who are losing the right to medical cards, bereavement grants and telephone allowances.

I refer to the bereavement grant. The Minister said the exceptional needs payment was still available in the community welfare office but there has been a cut in the overall heading for that payment. The bereavement grant has been abolished but the budget available for exceptional needs has been cut. People are being crucified twice here.

The provision regarding the telephone allowance has not been included in the Social Welfare Bill. Not only is the Government taking it away but the Minister dismissed it as being only a payment for line rental to various telephone companies. It does more than that; it gives people a landline in their homes and in rural areas, in particular, it allows them to have the emergency pendant, which they use for crime and health security. They face losing that because they must pay the full amount to Eircom due to a very measly cut. Since it is not included in the Social Welfare Bill, the Minister of State, Deputy White, might outline the Government's plans in regard to that cut.

Many departmental decisions have come down on the heads of one sector. Older people are paying the price for a way of government which has been practised by every government, so I am not personalising it to any Minister. It is time Departments started to co-ordinate approaches. Given the way this budget was devised, with last minute meetings and last minute rows, it was inevitable somebody would pay the price and it seems to be our older people. As the Government prepares for next year's budget, let us hope there will be more co-ordination so that one sector of society does not bear the brunt of budgetary decisions in the manner older people are in this budget.

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