Fergal Browne (Fine Gael)

It should not be forgotten that only a year ago a similar debacle occurred when the then Minister for Social and Family Affairs, Deputy Coughlan, wanted to restrict special entitlements for widows and widowers. The Government seems to have learned nothing from that debacle either. It is very worrying to see this trend continue.

I question the genuineness of the Government's attitude to this issue. Fine Gael has submitted a freedom of information request on this subject. This might explain the reason the Tánaiste was very forthcoming in releasing documents, in particular the interesting document relating to the meeting on 16 December 2003 at which Ministers were present. The then Minister for Health and Children, Deputy Martin, is now back-tracking by saying he arrived late for the meeting.

Serious questions remain to be asked. What were his Ministers of State doing at the meeting? Are they talking to each other? It is a pity that the Minister of State, Deputy Tim O'Malley, is not present in the House. I presume he is conveniently absent. The Minister of State, Deputy Brian Lenihan, cannot be blamed because he did not attend the meeting and the Minister of State, Deputy Callely, has moved to a different Department. Principal officers of the Department of Health and Children attended the meeting. What lines of communication exist in the Department? There seems to be an À la carte approach to picking the nice topics and not being made aware of the bad topics. The former Minister cannot abdicate his role in that area.

When Fine Gael was in Government, poor Deputy Owen as a Minister was blamed for everything by Deputy O'Donoghue who was then Opposition spokesman for justice. He gave the impression that the Minister was personally liable for all criminal activity. When Fianna Fáil is in Government it conveniently forgets and moves away from terms such as "collective responsibility" and the concept of a Minister being responsible for his or her Department.

It is worth noting the Government's recent acknowledgement that it has failed completely in the provision of medical cards. There are now 200,000 fewer medical card holders than in 1997. The Minister has introduced a new system of GP-only medical cards but this is only a short-term solution. It will not work out in the long term and must be reconsidered. The Minister has not clarified whether these recipients will progress onto full medical card cover over a period of time. These new cards have been described as "half medical cards" but they are less than that. Those in possession of a GP-only card will lose out on free prescriptions and free access to inpatient and outpatient facilities and orthodontic and optical services. They will lose other benefits available to the holders of full medical cards, such as the exemption for State examination fees. The Government's record in this area in the last year is atrocious.

By 2036, when most of us will no longer be involved in politics, almost one fifth of the population, or 1 million out of 5 million, will be over 65 years of age. The Government has not inspired confidence that it will initiate steps to provide for the care of the elderly in the long term. Almost 30 years ago, the Supreme Court ruled that medical card holders were entitled to free inpatient care, including in nursing homes. In 2001, the previous Minister for Health and Children, Deputy Martin, initiated a scheme to give medical cards to all over 70 years of age. He did not do his homework, underestimated the number of people involved and did not consult widely enough. The deal was apparently done at the 11th hour.

We are now seeing the results. An interesting aspect of this is that State subvention of nursing homes has gone from €15 million to €115 million in a short number of years. This scheme was a pre-election gimmick in 2001. The Cabinet, including the Tánaiste and Minister for Health and Children, should have seen the implications of this measure. The Tánaiste cannot point the finger of blame at the Minister, Deputy Martin, and walk away. That is disingenuous in the extreme.

Apparently, the Department first became aware of possible legal difficulties in 2002. However, the Irish Nursing Homes Organisation, INHO, claims the Department sought legal advice on the legality of the nursing home patient charges in 2001. Why has there been a three-year delay in this matter? In March 2003, the South Eastern Health Board gave the Department legal advice that the practice of charging medical card holders for nursing home care may have been legally unsafe. That health board stopped charging two nursing home residents on foot of complaints they made to the Office of the Ombudsman. An article in The Irish Times this week indicated that health boards did not charge pensioners who made complaints. Those who were able to speak up for themselves did not pay the charges while the weakest and most vulnerable members of society, who could not defend their rights, were obliged to make such payments. This is shocking. I hope never to see such a situation arise again.