John Dardis (Progressive Democrats)

Yes. For one person to undertake to compile the report and to complete it within such a short period is a monumental achievement, particularly in light of the number of years that were the subject of investigation and the amount of documents to be examined. Mr. Travers is to be congratulated for what he has done.

The constitutional imperative means that we are obliged to provide resources and to ensure there will be reasonable expenditure in respect of people. There is an important aspect of the Bill which dates back to what was originally intended to be dealt with by the chief executive officers of the health boards and which is now being dealt with by the Health Service Executive. Section 4(4) states:

The Health Service Executive may reduce or waive a charge imposed on a person under regulations made under subsection (2) on or after the enactment of this subsection if the Health Service Executive is of the opinion that, having regard to the financial circumstances of that person (including whether or not that person has dependants), it is necessary to do so in order to avoid undue financial hardship in relation to that person.

It is vital, particularly in the area of health, that people who are independent should have discretion to adjudicate as to whether someone should be liable for payments or whether they should be exempt. This is an important part of the Bill and I welcome it.

On the basis of the figures furnished to the Joint Committee on Health and Children earlier today, I understand that some 315,800 people, or their families or estates, will be eligible for repayments as a result of what has happened. This will expose the State to a potentially huge financial bill of between €500 million and €2 billion. I cannot understand how, as the report appears to indicate, people knowingly allowed this matter to drift to the point where the State could be exposed to such a massive extent.

If I understood what was said earlier today correctly, several political points were made as to culpability in respect of this matter. It is worth pointing out that six of the 16 Ministers who held office during the period of 30 years in question represented parties other than Fianna Fáil. Of these, only one, the late John Boland, who served in the interregnum between Governments as an interim Minister for Health, brought this matter to the attention of the then Cabinet. The report is explicit in terms of apportioning culpability. It states:

There were also shortcomings at political level over the years since 1976 in not probing and questioning more strongly and assiduously the issues underlying the practices of charges for long stay care in health board institutions even if, or perhaps even because, the analyses and briefings being provided by the officials in the Department of Health and Children appears to have been deficient in many respects. These shortcomings were, however, of a nature, scale, substance and order of magnitude considerably less than those of the system of public administration.

That is quite an explicit statement. The report proceeds to state that long-term systemic corporate failure occurred.

Senator Quinn made an important point regarding the supremacy of the law. We are all subject to the law and it is impossible for the Houses, the Government or local authorities to act ultra vires. Apart from the late John Boland, the legal advisers within the Department come out of this matter with considerable credit. It is obvious that over a sustained period, they were concerned about this matter to the point where they wanted action taken in respect of it. It is obvious that the South Eastern Health Board, as well as some of the other health boards, had similar concerns. Where did the blockage come from? When it reached a certain level, it just seemed to remain static. That was wrong and now we are paying the penalty. The Bill is important as it rectifies a situation that should have been cleared up a long time ago.

Some 200,000 people are eligible for free GP services. I hope that the free service will have a positive effect on the number of people presenting at accident and emergency departments. It is undoubtedly the case that some people are going to accident and emergency who could be treated by their GP. It would be preferable for them to visit the GP before presenting at accident and emergency, so that the doctor could make the referral. Many of these patients would be discharged rather than block up the system. Approximately 29,000 people presented to the accident and emergency department in Naas General Hospital last year. Kildare has a population of 160,000 people, so such a statistic represents a huge proportion of the population. One has to wonder why that happens.

This Bill also rectifies the deficiency regarding nursing homes. It fulfils the commitment of the Government to provide free GP services to those who are eligible. It deserves a quick passage through the House and should be enacted as soon as possible.