Martin Ferris (Kerry North, Sinn Fein)
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I welcome the opportunity to raise the matter of a painful situation for a 63 year old man, Brendan, and his wife Karen. In January, Brendan was diagnosed with liver cancer and had two thirds of his liver removed. Prior to that, he and his wife worked stacking shelves in two supermarkets in Tralee. Their combined income put them above the qualifying amount for a medical card so they needed to take out medical insurance. In this instance, that was unfortunate for them.

Having two thirds of his liver removed necessitated ten weeks as a patient in St. Vincent's hospital in Dublin. His wife took leave and stayed with him in Dublin while he received chemotherapy. Until two months ago, he underwent 14 chemotherapy sessions during 28 weeks. Every two weeks, he and his wife travelled from Tralee to Dublin. Their financial situation was desperate and they got tremendous help from the area's community welfare officer, who provided Brendan with a medical card to help with some of the expenses. All their savings were exhausted a month ago and they have effectively been left destitute.

Brendan asked Kerry General Hospital whether it could possibly provide him and his family with a subsidy for their travel allowances. It would have amounted to approximately €62 and covered his wife's train fare and the cost of a taxi to St. Vincent's hospital. However, he was told that because he was a private patient, he did not qualify for the subsidy. Consequently, his last four trips to Dublin have involved his leaving Tralee on the early morning train, a four-hour journey to Heuston Station, taking a bus into part of the city, going the rest of the way in other forms of transport, getting his chemotherapy treatment and making the return journey.

The man is terminally ill. At best and if everything goes well, he has two or three years left; at worst, he has less than six months. He applied to Kerry General Hospital for assistance in travelling to St. Vincent's hospital once per fortnight, but the response, even on appeal, was that a public hospital cannot be seen to subsidise a private patient of St. Vincent's hospital. Brendan and Karen said that the hospital was wrong and that the intention when rolling out the travel assistance scheme was not to discriminate against public or private hospitals, but to provide assistance to those who need to travel to other hospitals for treatment. There was to be no distinction. Even more outrageous than a terminally ill man with little money being refused such basic assistance was the suggestion that he become a public patient as he had a medical card and the transport section would then help him.

In this situation, which I am sure is replicated in many instances elsewhere, someone who pays his taxes, works hard and gets VHI or other medical insurance is being penalised because he did not incur upon the State expenses when he could have done so. He could easily have got disability benefits and a medical card and gone public. It has been suggested that he go into a public hospital, take a bed, when there is a shortage of them, and incur an expense on the State, which he does not want to do because he has paid medical insurance. According to the Department of Social and Family Affairs and the HSE, it appears that he is to be penalised. He is caught in an awful dilemma.

Rory O'Hanlon (Cavan-Monaghan, Ceann Comhairle)
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The Deputy's time has concluded.

Martin Ferris (Kerry North, Sinn Fein)
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I hope the Minister of State examines this matter as a human rights issue, namely, a person is discriminated against because he is not prepared to incur expenses on the State.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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I am taking the Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney.

Deputy Ferris appreciates that the issue he has raised relates to the exclusion of VHI patients from free travel for medical purposes. He has put on the record of the House certain matters as he is entitled to do, but the Minister is not in notice of those in respect of this matter.

I appreciate that Deputy Ferris has put a matter before the House wherein a patient was advised that, because he was a private patient with the VHI, he was in some sense disqualified from availing of the service. However, no distinction in law is made between persons with full eligibility or limited eligibility, or whether the patient is a public or private patient, that is, a patient with VHI cover. When a person makes use of an ambulance or other means of transport provided under this section, the HSE may impose a charge for the service. Again, I am not sure that is the point Deputy Ferris has raised this evening.

The primary focus of the ambulance service is on the provision of emergency transport for those patients with an acute medical need — the Deputy made the case that this person had an acute medical need. However, the HSE also arranges non-urgent patient transport services and examines requests for such services on a case by case basis, taking account of individual needs.

The HSE has advised that its national ambulance office, in conjunction with the primary, community and continuing care section and the National Hospitals Office, is arranging for a comprehensive review to be undertaken of the non-emergency transport needs of patients attending HSE facilities. That review will include an examination of the service delivered nationally and make recommendations that will inform its future development.