Fergal Browne (Fine Gael)

I welcome the Minister of State and his officials. I am not sure what the Minister of State's job was before he became a Deputy. However, I suspect after listening to him that he was involved in the building industry. He would certainly have a future as a plasterer because he has plastered over huge cracks in the Government's health policy as if they did not exist and as if all the problems have been solved.

The Government has been dragged kicking and screaming back into this Chamber with the Health (Amendment) Bill 2005. When we had the previous Bill before us in December, the Opposition warned the Government there were problems with it. The Government did not listen, but insisted on pursuing the matter and rushing the Bill through both Houses of the Oireachtas. Not alone that, it had the audacity to request the President to sign it into law sooner than the normal five days. The Leader of this House passed the motion for earlier signature. Fortunately, in her wisdom, President McAleese refused to sign the Bill into law early. She called a meeting of the Council of State and referred it to the Supreme Court where it was found wanting, as was the Government. This forced the Government to return to the House with this replacement Bill today. It is deeply regrettable that it took the President and the Supreme Court to make the Government aware of the seriousness of the situation and the fundamental flaws in its original Bill.

The Minister of State's speech was quite comprehensive, but I must raise some issues. He pretends that the Government welcomed the Supreme Court decision, but in reality it would have preferred that no case took place. It did not expect the court to find against the legislation. The Government had egg on its face in that regard. I must point out that while the investigative work of Fine Gael on this matter has resulted in a bill for the taxpayer, it has, no doubt, saved the taxpayer from a future massive bill. Had it not sought clarity on the issue, the illegal deduction of money would have continued for years until, perhaps, in 30 years time somebody caught the mistake. We can only imagine the size of the bill then. At least we have clarity on the issue now.

Fianna Fáil comes out badly from this issue. The Tánaiste admitted today that a former Fine Gael Minister, John Boland, when he was interim Minister for Health, noticed the difficulty with the charging of patients in nursing homes. He brought the issue to the Cabinet, but that Government fell and a new Government came in under the leadership of Charles Haughey with the Ceann Comhairle, Deputy O'Hanlon, as the Minister for Health. That Government should have introduced legislation to correct the problem but it was not done.

Senator Glynn referred to 1976. However, I believe the two main dates of relevance are 1987, when the Fianna Fáil Government came into power and failed to take action on the issue discussed by the previous Cabinet, and 2001, when the then Minister for Health and Children, Deputy Martin, introduced medical cards for all over-70 year olds, without consultation with the appropriate agencies or consideration of the long-term implications. The blame for this problem lies firmly with Fianna Fáil.

The Minister of State uses a word in his speech that reflects the Government's uncaring attitude towards the elderly. He speaks about the cost of treatment and "maintenance". He speaks about old people as if they were objects. In future, the Department should refrain from the use of the word "maintenance" when speaking about human beings. It is a cold and dispassionate word.

The Minister of State referred to the Government's policy on development and delivery of services for older people. This does not match the reality. I visited his constituency recently where I met a lady involved in the home help service. She gave out to me because as a home help her travel allowance had been cut. I presume this has happened around the country. She also complained that patients were assigned a maximum of ten hours help per week, irrespective of their needs, and that the home help situation has been radically changed by the Government. The Minister of State's words do not match the reality while the funding provided for the elderly is dismal.

The Minister of State also mentioned the new medical card scheme and that he hopes the new Health Service Executive will ensure a smooth transition. I understand there are major difficulties in this regard. Will the Minister of State clarify what talks have taken place so far in this area? Many general practitioners who have spoken privately to me have indicated that they foresee problems with the general practitioner-only medical card. They expect difficulties down the line. We must try to ensure that we avoid a repeat of the current debacle.

I am disappointed that the much publicised Bill on eligibility, about which the Tánaiste spoke here, does not appear to be any closer. I agreed with the Tánaiste when she stated there was a need for an eligibility Bill that would specify to what people were entitled. However, that Bill is not making any progress and we have a disjointed approach that will land us in more difficulty. It is important that the people know to what they are entitled. If this information had been provided years ago, we would have avoided the mess we are in today.

I understand that the two main differences between this Bill and the previous one are that the retrospective element and the medical card inclusion have been removed from it. The Government is being disingenuous on the medical card scheme. It gave a clear commitment in the most recent general election that it would increase the number of medical card holders. It has failed in that area and there are approximately 200,000 fewer people on medical cards. It is now introducing this "yellow pack" type medical card for general practitioner services only.

Fine Gael suggested this approach and the use of general practitioner-only medical cards, mainly to benefit parents who could not afford to bring their children to a doctor. If a child comes out in spots, parents need to know whether it is meningitis or a minor rash. The benefit of these cards is such that they will eliminate that worry by allowing such parents the freedom to visit their general practitioner. Unfortunately, the Government has hijacked this scheme.

Some people have said that these cards are only half a medical card. Significant benefits attach to medical cards such as free drugs, or exemption from exam fees for children doing leaving or junior certificate. A person on a general practitioner-only medical card will only get about one eighth of the value of a full medical card. The Minister of State's words do not reflect the reality. It is shocking that the Government's mishandling of the issue could account for almost one seventh of the Department of Health and Children's budget this year which, in turn, accounts for one quarter of State expenditure.

Fine Gael has serious concerns about the legislation. It is amazing that only one amendment was discussed in the Dáil yesterday. One wonders whether the Government learned anything following the debacle prior to Christmas when legislation was rushed through the Oireachtas. Everybody agrees that rushed legislation is bad legislation, yet a short, important Bill has been introduced and sufficient time has not been allocated to debate it properly. Committee, Report and Final Stages will be taken together tomorrow even though the Leader is on record as saying that is a bad way to do business.

The consideration of undue hardship for entitlement to a medical card for those aged under 70 will be decided by the Health Service Executive under section 1(a). That will introduce a new layer of bureaucracy. Section 1(b) refers to the means test for medical cards and Fine Gael is concerned this provision might discriminate against married couples because a spouse's income will be considered, which contradicts the Health Act 1970. Section 5 deals with traditional medical cards and doctor only cards.

If Deputies Perry and Kenny had not ruthlessly pursued this issue, we would not have reached this point. While the taxpayer might take a hit initially because of Fine Gael's work, we have saved the taxpayer money in the long term. The worst aspect of this sorry saga is that the patients who could speak up for themselves were not levied charges but those who could not were. The Secretary General of the Department of Health and Children has been scapegoated in the Travers report but there should be greater political fallout because Ministers must be accountable.