Speeches
Speech by Fiona O'Malley on the Health Amendment Bill
Speech by Progressive Democrats TD Fiona O'Malley on the Health Amendment Bill 2004, 16 December 2004
A Chean Comhairle
I welcome the opportunity to speak on this Bill today.
Firstly, I would like to address the charges being made on the Opposition Benches that we are 'rushing' through this legislation. If there was ever an issue that required speed of action by the Government, it is this issue. For every week that it goes unresolved, it is costing the exchequer €2.5 million. Is that what Opposition Deputies want? That the house leaves the matter unresolved, we break the Christmas recess today, and come back in January having amassed a bill of €30 million? As the Tánaiste said yesterday, that would mean a very expensive Christmas holiday for Deputies.
The fact of the matter is that this issue has come to the fore, and it needs to be dealt with quickly. Yes, it would be nice if there were more time for debate, but we all know that it is not possible, so I would appeal to opposition deputies to stop kicking their heels and deal with this matter promptly.
At the heart of this matter, is the fair and reasonable expectation that those who can afford to contribute to the cost of their long stay care should do so. As the Tánaiste said earlier, this belief has underpinned policies implemented by successive Governments and by Ministers for Health from all parties in Government, since 1954. This is not something now that the Opposition can throw their hats at, or walk away from.
The charges raised are directly used to support and provide for those people in this country who are in long-term residential care. It covers the cost of their board and lodging, and the provision of all necessary medical services and care.
Are the Opposition Parties now really suggesting that people in long-term residential care should not make a contribution from their state pension to this care? I want to reiterate the fact that we are operating on the principle that those who can afford to make a contribution do so. What we are talking about is a percentage of their pension, unless there is a dependent at home. We are not impovrishing anyone.
Good Government is all about priorities and making good, sound judgements. State spending is not a finite source. A decision not a to levy a charge on people in long-term care who have the means to pay, would mean less money to be spent on key services. Things are only for free for those on the Opposition benches. Parties in Government do not have that luxury and choices and decisions need to be made. All of us deputies know and understand, that long-term residential care is a highly labour intensive enterprise, and is thus costly. I think it would be extremely disingenuous of any member of this house to oppose the principle of taking a percentage of the state pension to pay for this care.
Any references or attempt to make comparisons with the recent overcharging scandal in AIB, and other institutions is muddying the waters, and highly unfair.
These illegal charges went towards the bottom line of these institutions in terms of profit generation. These charges went to provide necessary care services – no fair comparison can be drawn.
On the question of the compensation, the offer by the Tanaiste of an ex-gratia payment of €2,000 is generous, it is a sign of goodwill on the behalf the Tanaiste and of the Government. To anybody who suggests that we go beyond that figure, I would ask them from what area of the health service do they suggest that we take the additional money? What service would they like to see cut? Deputy Twomey is quite wrong when he says the Tanaiste is trying to put the 'blame' or responsibility on elderly patients and other persons requiring long-term care. This is not a question of blame, but as I said earlier, government funding is not infinite and the truth of the matter is that the longer this issue goes unresolved, the greater the cost to the state, and the less money that the Tanaiste will have to spend on key health services as we go forward.
I welcome the Government commitment that wherever possible, the monies will be repaid automatically, and every effort will be made to identify those persons who are entitled to an ex-gratia payment.
I want to pay tribute to the way in which the Tánaiste and the Minister for Health has dealt with this issue – speedily, openly and sensitively. As she said in her speech earlier, she first became aware of this issue in early November, and received further advice from the AG on December 8th. True to her political form, she acted immediately. There was no question of sitting on the issue, or delaying further. She immediately wrote to the Chief Executives of the Health Boards instructing them to stop levying charges until amending legislation was passed, and today we are now debating and passing that legislation. I commend the Tanaiste for the prompt and compassionate way she has dealt with this issue.
Finally, I was pleased to hear the highly respected and regarded civil servant Mr John Travers to appointed to conduct a review of the way this issue was managed by the department of Health. There are serious questions that remain outstanding – most importantly the question of why the advice of the Attorney General was not sought at a much sooner date.
We are embarking on a serious and ambitious reform programme. The Health Services Executive will come into being in January, replacing the ad-hoc, disprit and inefficient system presided over by the health boards. With the day-to-day running being handed to the HESA, the role of policy formulation, evaluation and legislation will take central stage in the Department of Health. It is fundamental therefore that we have the confidence that excellence in public service is the order of the day in Hawkins House. I look forward to the publication of Mr Travers report early in the New Year