Ulick Burke (Fine Gael)

Can Senator Daly tell his electorate in County Clare that, as of now, the Hanly report represents Government policy? What about the additional medical cards that were promised? The shortfall in the number granted represents another major problem. The Minister should selectively grant cards to diabetics, coeliacs and asthmatics who, because of the number of times they need medical attention, end up in accident and emergency units, adding to the turmoil. They should be granted cards on the basis of need and not income.

The Minister and other contributors spoke about home care packages. I have yet to find one person in east Galway who has been able to get access to such a package despite numerous requests. Why can the Health Service Executive in the west not indicate that it is available and the procedure to access it? Many people have said, and the Minister has said it previously, that the most important thing is to keep people in their homes for as long as is practicable. The HSE has made a miserly response to the provision of home care and home help in cases of great need. Families are trying to support and maintain people with reasonable dignity in their homes. Why is it not possible to provide an additional hour or two each week — never mind each day — to provide adequate support?

Some people say it is great to have one HSE with the equalisation of payments and access to various services nationally. However, that is not the case. Recently on the Adjournment I highlighted the nursing home subvention which is still not equal across the board. Many excuses have been given and continue to be given by the HSE western region why it provides reduced subvention payments by comparison with Dublin or elsewhere.

I have attended some of the briefing meetings when representatives of the HSE appeared before the Oireachtas Joint Committee on Health and Children. I am sure some of my colleagues opposite have done likewise. Across the board, regardless of political party, there was total dissatisfaction with the response of the HSE to representations made by public representatives. Never mind the responses to parliamentary questions in the other House, whenever we contact the HSE we are passed from one person to another and more often to an answering machine. We get excuses that a person is at a meeting or compiling a report. It is chaotic. We get neither transparency nor accountability from the HSE. Nobody is accountable.

I will give an example. Thank God one person eventually intercepted the issue. I made representations on a very urgent case immediately after Christmas on behalf of a person who had had a stroke and was in need of an electric wheelchair. She was 84 and her husband was 96. She was paralysed on one side and could operate an electric wheelchair to give some degree of mobility in the house. Eighteen months passed without a suitability assessment for that patient. I raised the matter at one of the Oireachtas joint committee meetings with the HSE and I was told it would be looked after. Nothing happened. I sent an e-mail to the manager of the HSE western region. Following five further transmissions within that region, this person who is in a managerial position intercepted and stopped the rot. I got a telephone call advising me that what had gone on was enough.

Other people had told me that the HSE professional, who would need to examine the patient in east Galway, was no longer in place and would not be replaced until April 2007. I pointed out that the patient and her husband might no longer be there because they would be either dead or institutionalised. Thank God that manager had the initiative to send somebody out and had the assessment carried out as an emergency. As long as people are pushing paper around in the HSE, nothing will be done. That cannot be called reform. When we had members of the health boards in the past, people knew somebody and could identify a person who had responsibility and would do the work or if it could not be done, would advise of that.

In December 2005 the Minister for Health and Children came to University College Hospital Galway and indicated the need for a neurosurgical unit in the new HSE area stretching from Donegal to Limerick. The National Hospitals Office-Comhairle issued a report contradicting this. It stated we had two units, one in Beaumont Hospital and one in Cork. I raised this matter previously on the Order of Business in the House. The consultant in Beaumont said that neurosurgery in Beaumont and in the country in general was in crisis. The three reasons the National Hospitals Office-Comhairle gave for rejecting it were the very reasons in favour of having such a unit. The people in Cork claimed we were encroaching on their area. They seem to believe that the preservation of catchment areas is more important than the health of the people in the west. Will the Minister of State, Deputy Seán Power, remind the Minister for Health and Children that she agreed with the need to establish such a unit in Galway? She should restate that need and confirm it will be provided.