David Cullinane (Waterford, Sinn Fein)

We have seen over the past ten years real improvements in healthcare technology, which are bringing tremendous benefits for patients and real opportunities for more care at home. I am sure Deputy Harris saw some of that when he was Minister for Health, and some of that evolving. However, it has changed and expanded exponentially over the past four or five years. We now see the HSE rolling out virtual wards and virtual beds where patients can be monitored at home. All of that is for the good.

The issue Deputy Doherty raises relates to home dialysis, which is a success story. We have 344 patients treated annually. Approximately 110,000 home dialysis treatments per year are carried out at home. That saves the HSE a lot of money. It obviously saves thousands of visits to hospital for the patients in the first instance. It also means that patients are not going into hospitals.

I have spoken to healthcare practitioners and people in the HSE on the wider issue of treatment at home where it is possible, where patients can be monitored and treated and do not have to go to hospital. That is what we should strive for if the technologies are there. They told me that one of the huge benefits of home dialysis was that it reduced the risk of infection for those patients, because people can get an infection or pick up an illness if they go into hospital. If you are on dialysis, that is the last thing you want, particularly now when we are coming into the flu season and there are respiratory illnesses.

There are a lot of benefits, and we want people to avail of and benefit from this. Obviously, if you are getting home dialysis, by its nature, your house has to be extremely warm. That requires a lot of extra power and electricity. The tax return benefits some of those patients and that is great. It does help and is a generous payment. However, as Deputy Doherty said, there are some patients who do not benefit, whether they are pensioners, people who may not be working or those who are carers. There is a range of people who stay at home, for example, single parents. There are categories of patients who are not covered by this.

Deputy Doherty outlined some alternative ways in which we could compensate people. Maybe it does not have to be a tax credit. You could look at a refundable tax credit. What the amendment is asking for is that the Minister would look at this issue and come back with a report with different options. One of them could be a grant system that might work. It is reasonable that we would want to be fair to everybody. If there are those who are probably the most deserving and most in need but are not getting the financial support, it does not make sense. At a time when we want more people to be treated at home and to reduce the need for people to go to hospital where we can, which would mean these patients would save the State millions of euro every year as estimated by Deputy Doherty, then it is important for us to make sure they are properly looked after.

We have made our point. I hope the Tánaiste will accept the amendment, and if he cannot, I hope he will accept the thrust of the arguments we have put forward in a constructive way. We hope it is something he will look at in the future with potential alternatives to ensure every one of those patients is covered and given the support they need.

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