Dara Calleary (Mayo, Fianna Fail) | Oireachtas source

A report is due next week, I gather, on "Prime Time" relating to Áras Attracta, an institution in my constituency which I know well. What we are led to believe is in that report is disgraceful and appalling. As public representatives, none of us can be comfortable with it. Why, ten years after the Leas Cross scandal, are we depending on RTE once again to shine a light on this issue? Someone in HIQA or the HSE has dropped the ball. Yesterday, we saw representatives from the HSE wringing their hands and saying that it was awful, but that does not excuse the HSE from responsibility. This has happened under either their watch or the watch of HIQA.

All of the constituency Deputies - I mean all of them - knew there had been resource pressures in Áras Attracta for some time. They are directly linked. The majority of the staff there do a very good job in difficult circumstances. It has served our community well. Since it is in her area of responsibility I call on the Minister of State to make the resource allocation necessary to bring Áras Attracta up to standard and to take the decisions necessary to restore its reputation. Once again we are depending on RTE to shine the light. Someone in the HSE or HIQA should have done that job. We cannot depend on RTE to give coverage or attention to every health care facility in the country.

I welcome today's report on the ambulance service. However what we need to see in the service plan but what is not evident is a detailed month by month implementation plan on where the allocations will be spent. In respect of the service plan for ambulances I welcome the staffing commitment to the bases at Mulranny and Loughglynn but when will the notice for staff be advertised? In what month will staff be in place at Mulranny and Loughglynn?

The ambulance personnel on the road are doing a phenomenal job. Tonight, God knows how many of them are facing unbelievable circumstances in trying to bring people to safety. However, those in management are disconnected from the reality. The difficulties we have in getting information from the National Ambulance Service makes North Korea look like a functioning democracy.

Last year the Minister of State intervened - I thank her for her intervention - to get information on an incident that happened in 2013 in which an ambulance took two hours to come to a case in Ballina. It took me three months to get that information. There have been two further incidents this year. The first took place in Castlebar in October, around the corner from Mayo General Hospital. Gardaí decided to bring the patient to the hospital because it was quicker than waiting for an ambulance to come around the corner. I have sought information on that case but I cannot get it because the service has moved its base to Ballyshannon. We are in a digital computer age but that is this year's excuse. Another incident occurred in Ballina town. Someone took ill in the middle of the summer and it took an hour to get an ambulance to the person in question. We cannot get information on that case either.

As well as investment in resources a change of culture is needed. The organisation should be more giving and sharing in respect of information. It is incredible that the organisation does not have basic management information, such as where vehicles are and the nature of incidents that have happened. That information should be available at the touch of a button. The notion of making public representatives beg for it and having to seek the intervention of a Minister are ridiculous. It amounts to those in the service telling this House that they have no respect for our role. It is time they copped on to themselves. It is time the management in the National Ambulance Service stood up and took responsibility for the service they are running rather than leaving the people who deliver the service to take the brunt of people's frustration.

Deputy Kelleher referred to the medical card situation. We all welcome last week's announcement but the reality is, as Deputy Kelleher has said, that it is still going on. Somewhere in Government Buildings a press conference was held. I do not doubt the intention of the Minister for Health, Deputy Varadkar, to change the system but somebody has forgotten to tell the people in the office in Finglas that this system has changed.

I will outline a case. The Minister, Deputy Varadkar, has the details. I will not name names. It involves an elderly couple. Both are retired, one is on a private pension and the other is on a social welfare pension. The man had a quadruple bypass earlier this year and is suffering from serious chronic obstructive pulmonary disease. He has an oxygen tank beside him everywhere he goes. The lady is suffering from a form of cancer which has claimed a number of members of her immediate family and she is currently undergoing treatment. The gentleman finds it difficult to leave his house.

They lost a discretionary medical card on 1 April this year. Since then we have been over and back with the service, like many Deputies. On 1 July the discretionary cards were re-approved and granted, valid from 26 June to July 2015. On the 12th of this month the lady went to register for chemotherapy and was told while having chemotherapy that her card was no longer valid. On the same day, while she was in Galway, the gentleman was at home. He received a telephone call from his general practitioner to say the card was no longer valid. Then he received a letter to say the cards, which were due to be valid to July 2015, had been withdrawn. They have not won the lotto in the meantime; there has been no change in their circumstances or income. We contacted the primary care reimbursement service. We received an e-mail from the PCRS on 17 November stating that those medical cards were valid and there was no problem with them. Then we got a letter on 18 November stating they were no longer valid because they had been reviewed.

One hand does not know what the other hand is doing. We challenged and queried this. New GP cards were sent out in the post. Now there are two valid GP visit cards and two full medical cards that are valid as well. There are four cards in the house.

A telephone call was received on 19 November stating that the GP card was no longer valid. We have been over and back to the PCRS. On 21 November someone from the PCRS rang the house to say it was all a mistake, that they were genuinely very sorry and two full medical cards were issued again on the basis of that telephone call. Then, last week we got an e-mail stating that the cards were being withdrawn and that a full review was under way. Last Friday I received an e-mail advising me that having queried the Department the PCRS could confirm that no further information could be added to the application in question and that since it has been previously reassessed, the application had closed. The e-mail stated that the letter dated 11 November referred. This was the letter that took away the card previously but which was subsequently replaced by e-mail stating the cards were still valid. This is what is going on.

All of this was in the case of a patient with COPD who cannot walk around his house without having an oxygen tank beside him and whose wife is in Galway having chemotherapy. One arm of the HSE will not talk to the other and as a result people are being put through trauma and stress. They should not have to ring my office. They should not have to endure the pressure of ringing my office and worrying about where the medical card is and whether they can afford the can of oxygen next week, but that is the reality. They have a small private pension and an invalidity pension but this is what they are being forced to do.

The e-mail of last Friday got a zinger of a response, which I copied to the Minister, Deputy Varadkar, because it seems the only way to get anything done is to get a Minister involved to talk sense. That is the new regime of medical cards.

Will the Minister of State clarify when the new regime actually kicks in? When will the local input actually kick in? When will there be some sort of justice or human touch rather than the "computer says no" approach, which is what governs how a medical card is issued in this country at the moment? It is time that humans said "Yes" in cases like this and in cases of parents with children with a disability or Down's syndrome.

It goes back to priorities. We will cut the tax rate for those on the highest rates but we will not give a child with Down's syndrome a medical card and we will force two old people to be put through the ringer like this. The priorities are so wrong. I am only one of 166 Deputies. Every Government Deputy will come to the House tonight with a script. The cheerleaders will say the Minister of State is the best thing since sliced bread, but they know the reality when it comes to medical cards and the ambulance service and so much else outlined in the service plan, as does the Minister of State, because they are dealing with it themselves.

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