Dáil debates

Tuesday, 22 October 2013

3:45 pm

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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It is very clear that the policy choices that the Government took last year and in has taken in this year's budget impact far more severely on children, sick people and our older population. Since July, Deputy Kelleher and I have been raising consistently the policy choice that the Government took last year to cull discretionary medical cards on an ongoing basis. Two weeks ago I raised this with the Taoiseach and I asked him to listen to people in this House and elsewhere on the discretionary medical card issue. We gave a range of individual cases where this was happening, but the Taoiseach chose to deny reality and he did not listen. It took Lydia Cleary and many others to come on "Liveline" last week to confirm once and for all what everybody knew, namely, that there was a wholesale withdrawal of discretionary medical cards from very sick children, very sick adults and people aged over 70. It exposed the untruths that were being articulated by the Taoiseach and the Minister for Health on the discretionary medical card issue.

Jonathan Irwin of the Jack and Jill Children's Foundation has provided further confirmation of this. A glance at that organisation's Facebook page shares the experience of many parents of children who are cared for by the Jack and Jill Children's Foundation and their experience of the medical card issue, in particular the discretionary medical card.

In addition older people have lost their discretionary medical cards. A 67 year old gentleman at end-stage renal failure lost his medical card. A 70 year old with very complex ongoing medical conditions lost his medical card. There are many more in life-threatening situations. The Taoiseach keeps saying there was no change. However, the 2013 service plan, approved by the Minister for Health, Deputy Reilly, stated that policy changes would lead to a reduction of approximately 40,000 medical cards as a result of changes to income calculations, including for those over 70.

3:55 pm

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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I thank the Deputy.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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That has been the case from the beginning and it is why letters have been issuing all year to different families and communities. That is why people are terrified about next year and the provision in the budget for a reduction of €113 million on the basis of this wonderful word "probity". They know what happened this year when the edict went out from Government to start removing cards from people. That is why people are concerned about random reviews that were initiated last year.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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Put the question, Deputy.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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Will the Taoiseach acknowledge that there has been an ongoing policy of withdrawing medical cards and will he intervene to reverse that policy? It is never too late to change. This has been one of the most disgraceful manifestations of what the Government has been up to in the past 12 months. People throughout the country are witnessing it. Will the Government also withdraw the budget decision to take 35,000 medical cards from those over 70 as a result of the reduction of the income thresholds?

Photo of Michael Healy-RaeMichael Healy-Rae (Kerry South, Independent)
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The Taoiseach should tell the thousands of people protesting outside that there has been no change.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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This is Leaders' Questions.

Photo of Michael Healy-RaeMichael Healy-Rae (Kerry South, Independent)
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Let him answer that.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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One of the fundamental reasons we need to make difficult choices and difficult changes in the structure of our health system is to cut the cost while preserving the services for those who need them. The main thrust of the changes being brought about is to protect services for those who need them - children, the sick and the elderly. We are doing that against a background of unmitigated disaster, which was aided in the main part by the gentleman speaking opposite.

Photo of Robert DowdsRobert Dowds (Dublin Mid West, Labour)
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Hear, hear. The Deputy should put on his sackcloth and ashes.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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We are on Leaders' Questions.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Deputy Martin was a member of a group that ran this country-----

Photo of Robert DowdsRobert Dowds (Dublin Mid West, Labour)
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Into the ground.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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-----when we had more money that would ever have dealt with many of the major problems we have to face. He failed to reform that service. He promised to end hospital waiting lists within two years when he sat on these benches.

Photo of Michael Healy-RaeMichael Healy-Rae (Kerry South, Independent)
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The Taoiseach made his fair share of promises himself.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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During Deputy Martin's 14 years sitting at the Cabinet table, the overruns in health amounted to €2.2 billion. He was the architect of the PPARS debacle which started at €9 million and ended up at €200 million. Above all, he promised to extend medical cards to an extra 200,000 people during his term, when in fact he cut them by 100,000.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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No, the Taoiseach is wrong again.

Photo of Robert DowdsRobert Dowds (Dublin Mid West, Labour)
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The Deputy should put on his sackcloth and ashes.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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The Taoiseach could not be right on that.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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He has the cheek to come in here now and use his opportunistic political opportunity to say these things. The Minister, Deputy Reilly-----

Photo of Robert TroyRobert Troy (Longford-Westmeath, Fianna Fail)
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Great man.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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-----against the most difficult economic background, has managed in these past two years to make serious changes to the structure of our health system, reducing the cost of the services, but protecting the services.

Photo of Michael Healy-RaeMichael Healy-Rae (Kerry South, Independent)
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Tell that to the thousands outside.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Deputy Martin said the policy changes were directed at children, sick people and old people. I do not suppose, therefore, that he wants to change tack in respect of 240,000 children under the age of five having free access to GP care.

Photo of Robert TroyRobert Troy (Longford-Westmeath, Fianna Fail)
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At whose expense?

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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I know Deputy Martin understands this because when he was Minister for Health and Children and the chief medical officer of the Department at the time suggested that free GP care should be extended to every child in the country, he supported it but then ran away and did nothing about it, just as he did with most other issues he faced.

In respect of discretionary medical cards, it is important to understand that the number of people with access to free GP care is the highest ever in the State. Some 43% of our population now have that access. There are 1.866 million full medical cards and 124,900 GP-visit cards, giving a total of 1,991,000. When people have a GP-visit card, it means they have free access to their doctor, which is the start of the analysis to determine what little problem they might have. On becoming Minister for Health, Deputy Reilly instructed the HSE to appoint a clinical panel to assist in the process of vetting applications for discretionary medical cards. That ensures the specific circumstances of a person with a particular diagnosis can be determined case by case. I want to say this to Deputy Martin, politician to politician, man to man, citizen to citizen: I saw some of the cases mentioned in the media and these were cases that the system should have been able to deal with-----

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
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Blame the system.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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-----but because of the process of change, something was missed. I know of two cases where the card has been granted in the meantime because of the full information becoming available.

Photo of Robert TroyRobert Troy (Longford-Westmeath, Fianna Fail)
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Because of "Liveline".

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
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Thanks to Joe Duffy.

Photo of Barry CowenBarry Cowen (Laois-Offaly, Fianna Fail)
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Ring Joe.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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According to the most recently published information, there was a reduction of about 24,000 in the number of discretionary medical cards between the start of 2011 and July 2013. Of those 24,000, some 23,000 were awarded a medical card on the basis of full assessment of their income. On Monday, 14 October, the Minister, Deputy Reilly, met the chief executive of the HSE and the primary care team to express concerns directly about the communications, the letters, the answering of phones, the interest being expressed in dealing with difficult cases.

This might be of interest to Members of the House. By 1 October 2013, of the 97,121 people who held discretionary cards at the time of the assessment in March 2011, 38,000, or 39%, still held a discretionary medical card, 43,000 had ordinary medical cards based on the assessment, and 17,000, or 18%, had no medical card. When that 17,000 was analysed, 2,361, or 14%, were deceased, 6,265, or 38%, did not respond to correspondence from the HSE and their medical cards were suspended, 12% engaged in the review process but did not follow it through, and 6,165, or 37%, completed the review process and were found to be ineligible for a medical card or a GP-visit card. That represents 6.5% of all the people who held a discretionary card on 1 March 2011.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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I thank the Taoiseach.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Yesterday I had a meeting with the personnel involved in this. A completely new communications strategy has been put in place to deal with people and allay their fears and concerns that those who need a medical card will get one and that those who require services will get them. As the Deputy knows, we have full medical cards, GP-visit cards, discretionary cards, emergency cards, long-term illness cards and cards on review. Sometimes these things can be very confusing. In fairness to the people who work in the HSE and want to be able to deal with these things, sometimes the information is not supplied. We are rectifying that.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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The Taoiseach did not answer the questions I asked. For example, I asked if the Government would reverse the decision in the budget to take 35,000 medical cards from older people and he studiously ignored and avoided answering that question. I think the Taoiseach must be the only person in the country who believes there has not been a consistent attempt and policy to withdraw discretionary medical cards from people. The Taoiseach should read up on the case of Ms Lydia Cleary and her daughter, Eirin. She made all of those points; it was not an issue of communications. It is not about hard cases. The Taoiseach should stop all of that nonsense. Thousands of cards have been taken from people throughout the country, as every Deputy in this House has acknowledged.

Eventually, the Taoiseach acknowledged it because his own Deputies got to him at their party's Ard-Fheis.

We all know what is happening and we have all instanced individual cases. Let us consider Katie Connolly's case this morning in theIrish Examiner. She is a young Down's syndrome child with juvenile arthritis. Her card is up on 13 November. It is policy. It should not have had to wait until yesterday when the Taoiseach intervened in this case. We have been saying this for months. It should have been when the service plan was approved last year, in 2013. The Taoiseach and the Minister for Health, Deputy Reilly, approved the plan in terms of a deliberate decision. It was a message to the HSE to find the savings in the General Medical Services, GMS, scheme. The Minister of State, Deputy White, confirmed it in May in the House before a committee. Let us consider the document that the HSE produced before the Oireachtas committee. It referred to the random reviews undertaken as part of the full suite of reviews to assist in determining that a medical card or general practitioner visit card meet the eligibility criteria. By God, the HSE has stuck by the new eligibility criteria.

Did anyone see the HSE official on "Prime Time" last Thursday night? Did the Taoiseach watch it? Christians among us would have been intrigued because on the third occasion he suddenly relented and it became evident that there was a change of policy. The interviewer identified one, two and then three policy changes in terms of the income guidelines in respect of medical card guidelines.

The Taoiseach should stop telling untruths to the public in respect of discretionary medical cards and stop all of this clever language to the effect that those who are entitled will get one.

4:05 pm

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
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What language is that?

Photo of Barry CowenBarry Cowen (Laois-Offaly, Fianna Fail)
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It is waffling.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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Those who have been entitled to it for the past year or two years have been denied it in case after case.

The pattern in the Taoiseach's replies is very consistent. For the Taoiseach, there is always someone else to blame for choices that are made on his watch.

(Interruptions).

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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Order, please. Calm down.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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Today-----

(Interruptions).

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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Deputy Martin, you are over time.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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I will conclude.

(Interruptions).

Photo of Michael Healy-RaeMichael Healy-Rae (Kerry South, Independent)
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Go and face the people outside.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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Today, very obviously-----

Photo of Michael Healy-RaeMichael Healy-Rae (Kerry South, Independent)
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Go and face the people outside.

Photo of Finian McGrathFinian McGrath (Dublin North Central, Independent)
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The Government is hiding.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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Today, it is the system.

Photo of Michael Healy-RaeMichael Healy-Rae (Kerry South, Independent)
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Go to the gate and face them. The Government ran from them today.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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Deputy, I told you already. Deputy Martin, to conclude.

(Interruptions).

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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I am endeavouring to conclude, a Leas-Cheann Comhairle. There is always someone else to blame. Today it is the system. Now, we have learned the Minister for Health, Deputy Reilly, has had meetings with the officials to tell them how to do communications better. I suggest that some of those officials are laughing behind the idea that the Minister, Deputy James Reilly, would give them advice on how to communicate better. That is a bit rich too.

The real issue I am raising today-----

A Deputy:

They should listen to Joan.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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I am not into personalities. It should not take the mother of a very young sick child to come on the national airwaves to get a decision reversed in respect of her entitlement to a medical card. That is the bottom line.

This is affecting thousands of families throughout the country. I called on a family yesterday to whom the same thing happened. They have a five-year-old with a rare chromosomal condition and the card was taken from that young child. I do not want to come to the House every week listing case after case, because when one gets case after case one begins to realise it is systemic and not simply one individual hard case or a failure of communications. It is systemic. That is the point which I and Deputy Billy Kelleher have been trying to get through to the Taoiseach for the last number of months. There is something systemically wrong and it goes back to a policy decision that the Government took on health in last year's service plan and in this year's budget, although the budget is now up in the air in respect of medical cards.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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The answer to Deputy Martin's question in respect of the change being brought about for over 70s and their medical cards is "No". There will be no change in that. I have already pointed out that 85% of the over 70s will still retain their medical cards.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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He said it was 97% last week.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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It will be in the high 90s and those who do not have a medical card will have the GP card which gives them free access to their doctor. The weekly income is €500 for a single person and €900 for a couple in order to receive a GP visit card and the House knows what that means. Even after the change, at least 93% of persons over 70 years will still have access to a free GP card. I said 97% last week on the basis of figures coming in.

I will say this much: I recall Deputy Martin saying on discretionary medical cards-----

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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I would be happy to debate that some other time.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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The question has been asked.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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It is not a case of having someone to blame. Deputy Martin put his foot in it and his footprints are all over the place. Deputy Martin said previously that there would be a clarification of the guidelines under which health board chief executives issue discretionary medical cards and that there were clearly variations between health boards in terms of how they administer them.

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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The health boards are gone eight or nine years.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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We should not have situations like those involving the children and their mothers who I saw on the television. We have 1.9 million medical cards issued. I put it to Deputy Martin that after speaking to these people directly there was a systems failure that did not take into account or did not know about the information involved, whether it be a failure on some of the people in sending in information. I was given an indication this week that some do not reply.

Photo of Robert TroyRobert Troy (Longford-Westmeath, Fianna Fail)
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Is the Taoiseach blaming the parents now?

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Some get scared when a letter comes from the HSE but we are changing all of that so that where children need attention or, in particular, facilities, aides or appliances, the system is able to cope with that.

Photo of Barry CowenBarry Cowen (Laois-Offaly, Fianna Fail)
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It is not.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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There is a centralisation of it whereby the assessment is the same for everyone whether in Donegal, Kerry, Waterford or Louth. The change in that structure has led to these cases being highlighted. I hope that out of all this difficulty for the parents and their children the matter will be addressed and it will be. I have spoken to parents myself.

(Interruptions).

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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The question is asked.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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I have spoken myself to parents in the last few days. We have had some exceptional cases where because of a lack of information or whatever they have been refused.

Photo of Barry CowenBarry Cowen (Laois-Offaly, Fianna Fail)
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It is because of policy decisions.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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The question of aides and appliances and the treatment of these will all be addressed. It may well be, as Deputy Martin rightly pointed out, that of all of the ministries, the Department of Health is the most challenging because one never knows what pressures may arise from difficulties in various parts of the country. The Minister, Deputy Reilly, is seeking, at central level, to cut the cost of the provision of the services and maintain services so that the children, the sick, the elderly and anyone else who needs medical attention can have it available as close as possible. The answer to Deputy Martin's question is that there will be no change now in the budgetary position which has gone through. These will be implemented.

There are challenges facing the health area but they can be met in the context of a change of culture and a change of structure which will bring about far more cost-effective services for all our people who need them. The evidence in respect of discretionary medical cards speaks for itself. Since the beginning of this year 20,000 new medical cards have been issued on a discretionary basis. Even in the middle of all that, when the assessments were taken into account, many of those people-----

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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There are 26,000 fewer medical cards now.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Many of them were well in excess of the guidelines for medical cards but because of the weighting attached to their particular discretionary requirements the cards were issued. Fully 20,000 new discretionary cards since the beginning of this year have been issued. Significant numbers of those people were well in excess of the guidelines set down.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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Tá seanfhocal ann a deireann - Is cuma le fear na mbróg cá leagann sé a chos. Cuireann an seanfhocal seo Rialtas an Taoisigh i gcuimhne dom. The Taoiseach said there would be no change in these awful, spiteful, shameful, sleekit measures that the Government has brought in. The Taoiseach must be aware that senior citizens are outside protesting. They are deeply concerned about the reduction of the over 70s medical card, the ending of the bereavement grant, the axing of the telephone allowance and the increase in prescription charges. The Government has now targeted €113 million in cuts to the medical card system in 2014. This will result in thousands of citizens who need medical cards losing them. This is not an issue of communication or a lack of information. This is a policy decision by Fine Gael and the Labour Party.

Let us consider some examples, which I sent to the Taoiseach last week. Let us take Kate McShane from Drogheda. She is just over a year old and has Down's syndrome. She has required heart surgery and will require long-term GP and hospital care. Let us take Ryan Healy, a seven year old with a congenital heart condition. He has been denied a medical card and so has Kate. To deny the full medical card to sick children reliant on medication is punitive, petty and unfair.

While the Taoiseach claims the Government is moving towards universal free GP care, it actually is moving in the exact opposite direction. The Government again has set its face against reversing any of these budget measures, which means that come what may or whatever happens, it will cut €113 million from those entitled to the medical card. The Taoiseach should outline to Members his vision of the type of small country that will emerge from these austerity policies. The Government is making the State the worst small country in the world in which to be sick or to grow old. The Taoiseach should outline his vision. What will be the product of these austerity measures? Will it be the best small country in the world for bankers and the elites? The Taoiseach should tell Members.

4:15 pm

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Ní chreidim sa rud a dúirt an Teachta ar chor ar bith agus ní fíor é.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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Is fíor é.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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This is the third budget introduced by this Government and it was introduced on the basis of sorting out the unholy economic mess with which it was left to deal, and the Government is dealing with it. I might point out to Deputy Adams that the changes which have been made in the agri sector mean that Ireland's exports will be between €10 billion and €12 billion next year.

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
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That was on foot of the Food Harvest 2020 programme drawn up by the previous Government.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Moreover, the most recent budget, which was pro-business, pro-enterprise and pro-start-up opportunity for so many people, means there is real opportunity for those who wish to get out and provide employment, as well as a chance to have a career themselves. The construction sector will be revitalised to an extent, hopefully effectively, by virtue of the credit that is available for people to get involved in reconstruction grants or in reconstructions or developments of their houses, aided and assisted by the scheme from the Department of Communications, Energy and Natural Resources in respect of assistance from the Sustainable Energy Authority of Ireland for insulation and so on. As for the impact and the challenge for the Government in providing opportunities for training, internships, apprenticeships, as well as JobBridge and Momentum-----

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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What of the elderly and the young?

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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-----an additional sum of €14 million has been provided there and is an example of further development.

Photo of Mary Lou McDonaldMary Lou McDonald (Dublin Central, Sinn Fein)
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That is pathetic.

Photo of Finian McGrathFinian McGrath (Dublin North Central, Independent)
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The Taoiseach should mention Grangegorman again.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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In addition, I note the recognition on the part of the Government of the sustaining of an industry and the creation of 15,000 extra jobs in the hospitality sector through the retention of VAT at the lower rate of 9%. Indeed, it also showed its understanding of the competition the newspaper industry faces by keeping the rate at that level for that sector.

In respect of the elderly, I still hold my strong view that by 2016, we will demonstrate we have left the bailout far behind us. We have put the shutters up on going back to the kind of culture that created all of that. Moreover, we will have an economy that is effectively run and that is running strongly in the interests of growth, prosperity and jobs for people-----

Photo of Pádraig Mac LochlainnPádraig Mac Lochlainn (Donegal North East, Sinn Fein)
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Enough of speaking notes. What about an answer to the question?

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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-----and in which resources will be available to provide facilities for elderly people through the primary care system and through a universal health care system that will provide opportunities and facilities for young children, the extension of the free GP care system, opportunities for those in the middle to have work, careers and opportunity, as well as for those who are elderly to live in a country with a sense of dignity and respect. I acknowledge it is difficult to make these changes. The choices are always unpalatable when one tries to shift a structure that is as ingrained as the health system had become over many years. Fundamentally, the Minister, Deputy Reilly, is focused on cutting the cost of the provision of services but keeping those services for those who need them, particularly children and the elderly, as well as those who are sick.

I might add to Deputy Adams that I also spoke in recent days to a number of parents with children who have particular difficulties. They are aware of the availability of the long-term illness card, as well as the capacity to provide aids, appliances and facilities. One couple told me they were not entitled to a medical card as both were public servants and they were well over the income limit. While they did not seek a medical card, they had children with particular problems and sought assistance in that regard and this is the flexibility of the scheme, where discretion and weighting to that discretion applies.

I hope both the case in Drogheda and the second case mentioned by the Deputy can be dealt with in that fashion and that those concerned can be given an understanding that this is still a caring country. Changing the system has not been easy where some applicants either have not responded or the information has not been full or complete. I guarantee the Deputy that the structure that now will be in place for dealing with all cases in the first instance will make clear to people that when reviews take place, it is important that they be replied to but that on the other end, there is empathy and understanding of the difficulties that families in particular may face from one source or another.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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First, I remind the Taoiseach the Government has no mandate to do what it is doing. Fine Gael has no mandate to do what it is doing and neither does the Labour Party.

Photo of Tom HayesTom Hayes (Tipperary South, Fine Gael)
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You often did things without a mandate.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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The Taoiseach stated it is difficult to make these decisions but these are the easy options. It is difficult to tackle the elites, the wealthy and those who actually are in power in the State. It is not difficult to tackle the elderly, those who are sick and young people. How does the Taoiseach expect the health service to survive a cut of up to €1 billion next year on top of the billions taken out of health over the past five years by this Administration and by Fianna Fáil? How does he expect it to survive at all? Moreover, this is not a mathematical question but one of ideology. Either citizens have the right to universal health care or they do not. The Government clearly believes they do not. Moreover, it is wedded to this austerity agenda in face of all the facts, all the disadvantage and all the hardship that is being caused, as well as all the destruction that is being inflicted on society, on communities and families.

To take the example of prescription charges, the Government promised it would cut them. When in opposition, the Government parties railed against Fianna Fáil when it introduced a change during its stewardship. However, the Government has increased this charge fivefold, despite giving a clear commitment during the general election campaign that the Minister, Deputy Reilly, would abolish prescription charges. The Government has also axed the telephone allowance, thereby increasing the social isolation of elderly people in rural Ireland in particular but also in urban areas.

A big question going about at present is whether the Minister, Deputy Reilly, should resign. That is a no-brainer, as of course he should do so.

A Deputy:

The Deputy has questions to answer too.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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However, I repeat the Government has no mandate to implement these policies. The Taoiseach talks all the time about the people and democratic revolution. I have a question for the Taoiseach.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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A question please, Deputy.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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Why does the Taoiseach not resign? Why does the Taoiseach not do the right thing, go to the people and let them have their say? That is what the Taoiseach should do. The Government should go and give citizens their say on its policies.

Deputies:

Hear, hear.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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That was constructive.

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
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Brass necks all round.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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I call upon the Taoiseach for his final reply. Order please.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Deputy Adams has great faith in Ireland really. He is the man who went off to America to get his health care provided by a private benefactor. I am glad to see he is in a good, healthy condition to raise these points here.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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The Taoiseach should answer the question.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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I might point out to Deputy Adams that an additional €100 million was provided in this budget for facilities for elderly people to give them one of the highest rates of pensions paid in Europe, to maintain their travel, electricity and heating allowances and not to have any change in their net income.

Photo of Finian McGrathFinian McGrath (Dublin North Central, Independent)
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What about their telephone allowance?

(Interruptions).

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
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Look at how upset poor Pat was by the taking away of €5 million from RTE.

A Deputy:

What about milking RTE?

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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Can we have some order please?

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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The mandate given to this Government was to sort out the unprecedented economic mess left behind by incompetence, greed and a culture to which we will never return. That is my mandate as Taoiseach-----

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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Half the people.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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-----and it is my privilege to lead the Government, which is making serious decisions to make serious changes to rectify this. I pointed out to the Deputy that there have been 16 consecutive months in which there has been a fall in the numbers on the live register.

Photo of Sandra McLellanSandra McLellan (Cork East, Sinn Fein)
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That is because they are all in Australia.

(Interruptions).

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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Order, please.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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The unemployment rate has fallen from 15.5% to 13.5%, consumer confidence is at its highest for six years and there has been a return in places around the country to confidence in the construction sector, which is very important. There are unprecedented levels of confidence and potential in the agrifood sector.

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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And poverty.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Deputy Adams does not wish to know these things because his deputy leader sitting beside him last week sought to confine all the young people to the dole for the rest of their lives.

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
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Joan wants to send them to Canada.

Photo of Michael Healy-RaeMichael Healy-Rae (Kerry South, Independent)
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To Abu Dhabi.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Sinn Féin does not see opportunities for them to get out to have an opportunity to have a job, a career or to have retraining or upskilling in the many areas of opportunity and potential in the time ahead.

Photo of Sandra McLellanSandra McLellan (Cork East, Sinn Fein)
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The Taoiseach is clueless.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Consequently, I do not accept Deputy Adams's premise for a resignation. The Government is not in the business of shirking responsibility, unlike some others on the far side of the Chamber.

4:25 pm

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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If he read the Irish Independent this morning, the Taoiseach would see who was shirking responsibility to whom. It was savage stuff.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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This is a case of dealing with reality and people's lives, and we will make those decisions in the fairest and most equitable way that we can.

Photo of Sandra McLellanSandra McLellan (Cork East, Sinn Fein)
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No.

Photo of Pearse DohertyPearse Doherty (Donegal South West, Sinn Fein)
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The Taoiseach does not understand it.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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In 2016 the people will have their opportunity to judge this Government on whether we fulfilled our mandate.

Photo of Michael Healy-RaeMichael Healy-Rae (Kerry South, Independent)
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And they will judge you.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Between this and then we will continue to make our decisions in the interests of our country and people in the fairest and most equitable way we can. Things are not easy and decisions are never easy. It must have been great to do budgets in 15 minutes when you had mountains of other people's money to throw out without any responsibility.

Photo of Timmy DooleyTimmy Dooley (Clare, Fianna Fail)
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The Taoiseach had even more-----

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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Order, please. I call Deputy Clare Daly and I ask Members to have respect for the speaker.

Photo of Clare DalyClare Daly (Dublin North, Socialist Party)
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I thank the Leas-Cheann Comhairle for that. The Taoiseach's responses to the previous speakers reveal what a fantasy world he lives in, one which has no bearing on the real lives of ordinary citizens. Does he not think it is an indictment of his Government that the grey army has had to take to the streets again on this wet and miserable day, not to enrich themselves and not for their own personal gain but to defend the idea of society's social wage, the rights and entitlements built up over decades that make the difference between a decent civilisation and absolute poverty, rights and entitlements which the Taoiseach's Government has consistently stripped away, not because it is necessary and not because it does not have another choice but because of its relentless pursuit of the ideas of neoliberalism?

I do not think the pensioners will be alone. They will probably be joined on Thursday by another section of society. This time it will be Dublin Bus workers, who face their fourth ballot on the so-called new restructuring plan, which obviously is not new at all and is just a rehash of the previous three. The Government can dress it up anyway it likes, what is being proposed for these workers is the taking of more than €6 million out of their pay packets as part of a rationalisation package of more than €12 million, the erosion of their jobs and conditions and the bringing in of a race to the bottom, and just in case they might have the neck to reject that package again, the Government has focused their attention. The Taoiseach's Ministers have come out and told them there will be very stark consequences if they vote "No". Reminiscent of William Martin Murphy, these people are being told "vote for this, or else". Capitulate or the alternative will be worse. They are aided in this by the media chorus telling them why this cannot be done and asking what is wrong with Dublin Bus workers when everybody accepts being bled dry.

Not everybody else accepts being bled dry. The members of ASTI, the junior doctors and the tens of thousands of other workers who voted against the recent pay deals do not accept it. At the heart of this discussion, as with the protest today, is what type of society we want to live in and what will be the Government's legacy. Public services cost money and it is not good enough for the Taoiseach to expect workers to pay for that out of their wage packets because his Government is not prepared to invest and properly subsidise a decent transport system in this State. The reason it is not prepared to do that is not that it does not have the money, it is that it is too busy subsidising the wealthy.

Like many citizens, I thought the Taoiseach has some neck yesterday to give his address to the nation and talk about a welfare dependency culture, a code for an onslaught on poor and vulnerable people, but he said nothing about the dependency culture of the parasites who got us into this mess in the first place, the people he has no problem bailing out and subsidising. Instead he prefers to go to low-paid bus workers or pensioners and ask them to pay up.

When is the Taoiseach going to end this economic and social lunacy and start investing in public transport and services and stop expecting workers to pay for this through an erosion of wages and conditions, stripping these companies bare and facilitating a privatisation for the wealthy interests he so clearly represents?

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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The Deputy covered a lot of ground in her speech. As I said in response to Deputy Adams, the budget included €100 million more to maintain pensions for the elderly at a very high rate, much higher than in many other countries in Europe. I made the point that the State pensions, the carers scheme, the free travel and the free television licence have not been touched. Neither has the free fuel allowance because it is important. The tax treatment of the elderly remains unchanged with no change in net income for pensioners under this particular budget. Those who are aged over 65 will continue to have more favourable tax treatment than any other taxpayers in the country. That favourable treatment has been protected in the budget. The preferential treatment for the elderly in terms of the universal social charge, USC, remains in place whereby a person aged 70 or over will not be liable to the highest rates of USC, if his or her income does not exceed €60,000.

Photo of Dessie EllisDessie Ellis (Dublin North West, Sinn Fein)
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So they had no reason to protest, had they?

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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The USC does not apply to social welfare payments, including pension payments made by another state or any other territory and of a similar nature to State pension payments.

Photo of Finian McGrathFinian McGrath (Dublin North Central, Independent)
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Get up on the lorry and tell them that.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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I advise Deputy Daly that such payments will not be taken into account in determining if an individual has exceeded the €60,000 threshold. These are all protectionist measures and facilities because we recognise the importance of the contribution made by elderly people over the years. As the Deputy will be aware, those aged 66 and over are not liable to pay PRSI on any of their income, including their unearned income, in comparison with an average worker on €33,000 per annum who faces a marginal tax rate of 52%, including income tax, universal social charge and PRSI payment.

There are no increases on excise on fuel or on the 23% or 13.5% VAT rates, and all these measures are positive for the elderly. The bereavement grant has been removed. In the event of a death, the remaining spouse, civil partner or cohabitant receives six weeks of the payment after death. In addition, to that, anybody who faces genuine financial hardship in respect of a bereavement or a funeral can obtain assistance from the Department of Social Protection under supplementary welfare support.

There are also a range of additional supports for people following a death and which are worth considerably more than the bereavement grant. For instance, there is the widow's, widower's or surviving civil partner's pension, which is a weekly pension based on contributions or a means test. Second, the widow's or the surviving civil partner's grant is a once-off payment of €6,000 where there is a dependent child up to the age of 22 in full-time education. There is a guardian's payment where a person is looking after an orphaned child. If a person dies as a result of an accident at work or occupational disease, a special funeral grant of €850 is also paid.

The level of the living alone allowance has been maintained at €7.70 per week. There is a commitment from the Minister, Deputy Hogan, and the Minister for Social Protection in respect of the senior alert scheme. The level of coverage between the full medical card and GP-visit card for everybody over the age of 70, even after the changes are implemented, will be 93%. The announcement of an additional €200 million in the budget in new capital projects includes 5,700 grants for adaptation of houses for the elderly and the disabled.

As the Deputy will be aware, the DIRT measures do not affect married couples aged 65 and over with incomes below €36,000 or single people aged over 65 with incomes below €18,000. These are measures that have been introduced and maintained and protected for our elderly people. Therefore, the Deputy's charge of all these items being stripped away is invalid.

In respect of the Deputy's comment on Dublin Bus and in terms of that issue, I hope the workers will accept the proposals. Despite the introduction of a number of cost reduction measures, Dublin Bus has lost €84 million over the past five years and this level of loss is unsustainable. The Labour Court recommendations to achieve the savings have been accepted by the non-driver grades in the company but rejected on three separate occasions by the drivers, as the Deputy will be aware. The Government, ICTU and IBEC have together made one final attempt to resolve this and engaged industrial relations personnel who went into the company to examine in great detail and to analyse the issues which led to the rejections. Those people have published a set of proposals for operational change which will address the concerns of the drivers while enabling the Labour Court recommendations to be implemented, and I hope these can be accepted. I understand the drivers are balloting on the proposals later this week and I hope a positive outcome will result. It is in the interests of the drivers of the company and of the citizens at large.

Photo of Clare DalyClare Daly (Dublin North, Socialist Party)
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I am beginning to wonder if the purpose of the Taoiseach's response was to put us into some sort of hypnotic trance whereby he just mumbled back the same nonsense we have been hearing for weeks and does not address any of the issues raised. When one cuts through the waffle, what he is actually saying is that the citizens who built this country over decades of work and who are outside the gates of this House in the rain are obviously missing something, that they are obviously deranged and that they do not understand the wonderful paradise on earth that the Government has created for them. However, it is the Taoiseach who is out of touch and they are ones whose feet are on the ground.

If on paper a pensioner's income in Ireland is more than it is in other European countries, that is because the purchasing power they have and the lack of social services they can access with that money is considerably worse than anywhere else in Europe. These people do not deserve to be bled dry. The Taoiseach talks about them being given favourable treatment. The reality is that the only favourable treatment that has been meted out by his Government is to the wealthy in our society. The top 10% of earners now share the same in that regard as the bottom 10%.

The Taoiseach spoke about us not being able to afford public services. The reality is that we have cut public spending by about 40% since 2008 and at the heart of this is a sea change in social policy. Can the Taoiseach not admit that his Government is wedded to the ideas of neoliberalism and that his strategy is to strip public services to facilitate privatisation and a race to the bottom?

I understand why the Taoiseach is out of touch. It is because his friends in the likes of Independent News & Media, who got a big subsidy and bailout from this State of about €60 million, clap him on the back and tell him he is doing a great job.

Dublin Bus is a vital public service. It is not supposed to break even. It should be subsidised because we have the lowest form of public transport subsidy of any European country. I would like the Taoiseach to explain the reason Dublin Bus workers, who have a modest wage, should forfeit that to facilitate a process whereby every year €50 million is allocated for the West Link toll bridge, a project that was paid for twice over.

4:35 pm

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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Thank you, Deputy.

Photo of Clare DalyClare Daly (Dublin North, Socialist Party)
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Millions of euro are given out every year in public private partnerships for roads that are not being used yet buses which are being used cannot get an adequate level of subsidy. It is upside down economics and it demonstrates how out of touch the Taoiseach is.

Photo of James BannonJames Bannon (Longford-Westmeath, Fine Gael)
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The Deputy is anti-rural.

Photo of Michael KittMichael Kitt (Galway East, Fianna Fail)
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I call the Taoiseach for a final reply.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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I hope the Deputy's attempt at derangement, waffling or mumbling speaks for itself. The Department of Social Protection pays €75 million a year for free travel. Whether the Deputy likes it or not-----

Photo of Joe HigginsJoe Higgins (Dublin West, Socialist Party)
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Do not start that again-----

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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-----contributory and non-contributory pensions in this country for our senior citizens are among the highest in Europe. The ESRI, which, for the Deputy's information, is a completely independent body, has said that since the bank guarantee and all of the adjustments that have taken place, elderly people have lost about 1.4% in all of those adjustments.

Deputy Daly might think that her feet are more on the ground than anybody else's but does she think it is not right and fair that people should have allowances for free travel, free electricity or free fuel?

Photo of Gerry AdamsGerry Adams (Louth, Sinn Fein)
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Come on.

(Interruptions).

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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Does she think it is not right and proper that the contribution made by these people-----

Photo of Micheál MartinMicheál Martin (Cork South Central, Fianna Fail)
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That is sleeveen stuff.

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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-----over past generations should be reflected in favourable treatment in the way the country looks at them in terms of tax, the universal social charge, USC, or exemptions in respect of PRSI payment?

Photo of Barry CowenBarry Cowen (Laois-Offaly, Fianna Fail)
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Charlie Haughey-----

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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As I have said to the Deputy, on the question of Dublin Bus, which is a fundamental service for the public in this capital city of our country, the non-driver grades have accepted the recommendations. The drivers have rejected this on three occasions. The best personnel that could be got from the Government, from ICTU and from IBEC have made a genuine last attempt-----

Photo of Joe HigginsJoe Higgins (Dublin West, Socialist Party)
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IBEC. The Taoiseach should go out and drive himself for a week-----

Photo of Enda KennyEnda Kenny (Mayo, Fine Gael)
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-----to see that all of the issues that were of real concern to the drivers would be analysed in terms of the Labour Court recommendations. I hope the drivers in their ballot this week will accept the recommendations based on the proposals from the personnel who went in there to examine them. It is an essential fact of life, whether the Deputy likes it or not, that Dublin Bus be returned to viability. That case has been made clearly by the Labour Court and by the recent independent investigation report. I hope the drivers, in their balloting this week, will accept the recommendations and have Dublin Bus back on the street providing a very valuable service for the citizens of this city and for those who visit it from both at home and abroad.