asked the Minister for Health if his attention has been drawn to the fact that the Midland Health Board is operating a policy of withdrawing medical cards immediately on the admission of patients to long-stay hospitals and homes in order to justify levying daily maintenance charges for in-patient services on persons with full Health Act eligibility; that the Midland Health Board is further levying daily charges from the patient's date of admission rather than after 30 days; whether similar policies are in operation by other health boards; if so, the health boards in question; if he will issue an immediate directive to health boards to desist from these practices; the total amounts of moneys thus collected by each health board for each of the past three years; the way in which he proposes to have money thus demanded refunded by health boards to the patients concerned; and if he will make a statement on the matter.
Ceisteanna—Questions. Oral Answers. - In-Patient Services Maintenance Charges.
I would refer the Deputy to my reply to Parliamentary Question No. 214, column 1287 of the Official Report of 22 November 1988 from which it will be quite clear that the Midland Health Board is not acting illegally in this matter.
Persons who are in receipt of institutional assistance in long-stay homes may be required to contribute towards the cost of their maintenance from the day of their admission under the Institutional Assistance Regulations, 1954, as amended by the Institutional Assistance Regulations, 1965. Persons with full eligibility are also liable to make this contribution.
Does the Minister regard this as acceptable policy? Does he accept that old age pensioners on non-contributory pensions should merely have pocket money returned to them and that they should be expected to make that level of contribution to health board finances? Does he propose to allow such practice to continue?
Yes, that is an acceptable practice and has been acceptable to my predecessors right back to 1954 when the institutional assistance regulations were first brought in. Indeed, I might point out that apart from the Midland Health Board area, the South-Eastern and Eastern Health Board areas take 75 per cent of the income, 25 per cent being left to the patient for personal needs. The Southern Health Board take 80 per cent. The North-Western Health Board give the patient £7.50 a week. The Western Health Board patient receives £8.50 a week. The North-Eastern Health Board patient receives £12 a week. The Mid-Western Health Board patient receives £13 a week. It is normal practice throughout the eight health board areas and has been for many years and I accept it.
A brief question, Deputy.
Does the Minister find it acceptable practice that the Midland Health Board should cancel medical cards for all long-stay patients admitted to designated hospitals and return these to them once they have been released from such hospitals?
Yes. When patients are in long-stay residential care, their maintenance is provided and also their medical care. It is not necessary for them to be in receipt of a medical card or, indeed, to have a medical card. The boards, when deciding how much of the pension will be taken, make allowance for any commitments the patient might have, such as rent, mortgage, insurance premiums, hire purchase payments. A reasonable amount, as I have already pointed out, is left to the person to meet his or her personal needs.
A final supplementary question——
I am sorry, Deputy, I am obliged to go to the next question from Deputy Ivan Yates.
May I ask a further supplementary question?
I am sorry, Deputy.
Could I ask the Minister to regularise the position on a national basis, rather than have the boards work independently?
I again call Question No. 65.