Mary Henry (Independent)

I welcome the Minister of State. The Ombudsman and her predecessors in the office have been praised, quite rightly, by all sides of the House. When they were appointed, we all knew the job they would have. However, no Member realised how they would seize it with such enthusiasm. Many people are grateful to the office of the Ombudsman when they were not in a position to seek legal advice or their cases were unsuitable to go before the courts. The holders of the Ombudsman's office are owed a great debt of gratitude.

The report is not very long but it is interesting. I welcome, as the Ombudsman has, the appointment of the Ombudsman for Children. Ms Emily Logan is a sad loss to the National Children's Hospital; however, she is highly experienced in dealing with children and has a splendid background for the job. I look forward to seeing her report next year which I hope is produced with the same speed as this one. It is good the Leader of the House has arranged for the report to be debated in the House so soon after its publication. These reports should not just be considered historical documents. There is little value to reports that gather dust in the Oireachtas Library. I am always anxious when a document is laid before the Houses of the Oireachtas because it can mean the end of it. However, that has not been the case with the reports of the Ombudsman. All Members have seized on them because they are interesting and so apposite to what we do, making them good and useful reading.

Some of the cases in the report on medical provision need to be publicised more. One case concerned the Midlands Health Board and the provision of orthodontic treatment. The delay in getting orthodontic treatment for children is a serious problem in all health boards. When parents see their children with a jumble of teeth and how, through the lack of treatment, it affects them psychologically and physically, they often seek treatment from a private scheme. The Midlands Health Board has a three year waiting list for orthodontic treatment. In one case cited in the report a mother decided, after some time, that she would bring her child to a private practitioner who removed one of the child's teeth. When eventually the child was called by the orthodontic dentist employed by the health board, it was noticed that treatment had already begun with a private practitioner. The dentist involved said he could not continue the treatment under the public scheme and that the child would have to return to the private practitioner. The child's mother felt this was unfair as she had not been made aware that the child, if taken to a private practitioner, would be taken off the public list and, moreover, since the health boards, as the Minister of State is aware, frequently employ private practitioners to do public work. It was hard for the woman, who was simply trying to do the best for her child, to find that she would have to bear the whole cost of treatment. However, the Ombudsman got the health board to give an ex gratia payment of €1,000 towards the costs of the child's private treatment.

Cases such as this need to be made more known. As a member of the Joint Committee for Health and Children which has debated the difficulties in orthodontic treatment provision for the past four years, I cannot recall a situation where those who availed of private treatment were taken off the public list. Parents, whose only wish is to do the best for their children, could easily find themselves in such a situation. The three years waiting list in the Midlands Health Board is much shorter than in other areas. Some children, reaching adolescence with unattractive teeth which may be prone to rot, will seek some private treatment. However, they will find that they strayed over a line and must then go the whole hog with private treatment. This may not have been their choice, particularly in view of the costs of orthodontic treatment. The Ombudsman's report highlights the need for the provision of explanatory leaflets to parents of children on orthodontic waiting lists.

I was surprised by the case in the East Coast Health Board area of a woman who was charged maintenance in a hospital, though her husband had a medical card. The one thing that should have been as clear as a bell to everyone was that people who have medical cards should not be charged when they are in hospital. It is very odd that a sophisticated group of people such as those who run the East Coast Area Health Board should charge a person €45 per day who was not liable to pay. This is sloppy behaviour and I wonder how often it goes on. While some areas are fairly obscure — for example, people might not know they were obliged to go either totally public or totally private — I thought everyone in the country would have known this since medical cards were introduced. I cannot understand how it happened that this woman was charged.

When the Ombudsman pointed out to the health board that this was wrong, the money was refunded. The amount concerned was €7,746.30, which is a large amount to anyone but for someone whose income level allowed her to have a medical card, having to pay this amount would oblige her to economise heavily in other areas. Nobody would wish to do this and any health board that behaves in this manner needs to be severely reprimanded.

The Ombudsman said that the error should not have occurred, but there was no element of compensation to cover the loss of purchasing power in the intervening period until the woman was refunded her money. She could have failed to receive any compensation at all if it were not for the fact that the Ombudsman continued to complain about this and managed to obtain €2,102.58 extra based on the consumer price index.

This sort of thing should not happen. The Ombudsman only gave sample cases but from quite obscure areas to matters that are perfectly straightforward and well known by the public and should be known by every official in the land, it is unfortunate to see cases such as this coming before her. They should not arise in the first place. I commend the Ombudsman on the splendid job done by her and her predecessors. I hope that cases such as these, which she should not have to deal with, are investigated carefully by those who run the health boards.

Like other Members, I recently received a letter about the complications of the EU subsidy scheme, which are also creating work for the Ombudsman. It is a most complicated scheme to understand. However, the examples I have given here, especially the case in which a person with a medical card was charged by a hospital, should not have arisen. I hope the Ombudsman's office is freed from such complaints in future.