Deputy Bernard Allen has been given permission to raise on the Adjournment his concern that adequate `flu vaccine be available to elderly medical card holders.
Adjournment Debate. - Influenza Vaccine Availability.
Thank you for the opportunity, at long last, to address one of the issues on the Adjournment. I ask your permission to share my time with Deputy Lee and Deputy Rabbitte, since both Deputies had an interest in the subject over the last number of days.
Does the Deputy realise that he has a total of ten minutes? I hope everybody speaking will realise that.
By the Minister's own admission in the Seanad yesterday we are facing the worst `flu epidemic in 14 years. We now find ourselves chasing all over Europe for vaccine for our young people and our elderly. The World Health Organisation indicated earlier this year that an epidemic was on its way. That epidemic has been raging in Britain for a number of weeks. We all know it was certain to spread to this country especially with the number of people who will be travelling between both countries during the next few weeks. We are in a position of total confusion at present with the epidemic hitting this country. Instead of the health boards and the Department of Health working in a cohesive manner to help out the less fortunate in our community we have seen the health boards, the Department of Health and the Minister almost working against each other. This is just another example of the ongoing conflict between the health boards and the Department of Health. Along with this problem we have the Department of Health and the doctor's organisation arguing about who pays whom when the priority should be that elderly and young people should be protected.
There is a grave responsibility on the Minister and his Department to eliminate the problems of bad planning, delays, indecision and conflict. One of the above issues might be a source of danger to our elderly population, especially those who are ill, but all of these together could be a death sentence for some of our elderly.
Despite the Minister's lengthy answer in the Seanad yesterday he did not deal with the issues that were raised. I would like the Minister to deal with some specific issues and questions which I will now put. First, the Minister must give clear-cut assurances to this House that adequate doses of vaccine will be available for all our elderly and young people in the weeks ahead. Second, he must give assurances that the dispute between himself and the doctors' organisation about payment be clarified once and for all. Third, he must ensure that enough beds are available in our depleted hospital services to cater for the almost certain increase in demand in the weeks ahead. We do not need glib answers such as we got in the House yesterday, for example, if there are empty beds there will always be people to go into them. The evidence in recent weeks, from answers in the House, is that we have waiting lists in each health board area. If there are beds available there are sick people to fill them.
What discussions have taken place between the Department of Health, the acute hospital services and the primary care teams concerning the problem that is now arising. Unless the Minister gives clear-cut answers I submit that he is being negligent in his duties as Minister, that the health services are in a shambles, and here we have an issue which has shown him to be inept in the performance of his duties.
In regard to the elderly people in this community, I do not think we should overstate the danger in relation to the epidemic. The dangers can be adequately dealt with if the Minister gets his act together. I would like clear-cut answers to the fairly clear-cut questions put here this evening.
I might formally advise Deputy Lee that the basis on which the question was allowed was the availability of 'flu vaccine and you cannot wrap it too widely in three minutes.
I thank Deputy Allen for giving me the opportunity to speak on the unprecedented blunder by the Minister and his secret advisers in not making, once again, provision for the health of the people of Ireland. Sadly, one has come to expect this under the present two-tiered health system begotten under the most uncaring and unchristian administration this country has ever had. The Minister's dirty tricks department, which all doctors know is in existence in the Custom House, and The Workers' Party have now introduced a red herring into the equation in that GPs are charging medical card patients £5 for the 'flu vaccine. This is true in part but it is totally taken out of context. What the Department have omitted to say is that some GPs had already purchased and had in stock the 'flu vaccine. The Department was not in a position, because of incompetence, to have this vaccine in stock.
Should the doctors pay for the vaccine which under the Health Act the Minister should provide? In other words the doctors had the foresight which the Minister and his secret advisers had not. The Minister's dirty tricks department and his secret advisers have allowed this smoke-screen to cloud the issue. The Minister had deliberately fuelled this dastardly rumour. His dirty tricks department and his advisers are endeavouring to deflect, to deviate, to confuse, to abscond in the smog which he has created and away from the fact that his Department are totally incompetent and totally out of touch with the people who run the primary health care system which the Minister has created.
Deputy Rabbitte has about four minutes.
I would like to express my appreciation to Deputy Allen for allowing me to share his time. Since I first raised this matter, by way of Private Notice Question on Tuesday, the confusion has grown and the conflicting statements have expanded. I have here the unrevised text of the Minister's answer to my questions in which I raised the question of the adequacy of the 'flu vaccine supplies. We found a statement about one hour earlier from the Eastern Health Board to the effect that the 'flu vaccine supplies would be exhausted within a matter of hours.
On the question of the charge for administering the vaccine to medical card holders the Minister said:
I am unaware of any decision of the Eastern Health Board to allow doctors to charge a fee of £5 for the vaccination and I would be interested in getting the details from Deputy Rabbitte. I will bring up the question of the £5 fee because I believe the Eastern Health Board would not charge a £5 fee to medical card holders.
Within hours of that statement by the Minister his officials were quoted in the Evening Press of 12 December to the effect that the doctors are entitled to charge a fee for administering it, that is the vaccine shot. This kind of confusion has continued. I supplied the Minister with the details he requested. I supplied him with the particular circumstances of a mother — a medical card holder in my constitutency — who attended her local GP with three asthmatic children requiring the operation. When a demand was made for £15 to administer that injection the woman was not able to avail of it. As a result the three asthmatic children were not vaccinated. There are other examples. I provided those details — names and address — in confidence to the Minister. The latest position this morning, according to The Irish Times report, following research with the Department, is that:
The question of whether doctors are entitled to charge medical card holders a £5 fee for administering the vaccine remains unresolved.
Dr. Joe Currie of the IMO Ethics Committee told The Irish Times that it was up to the Department of Health to resolve the situation. The Minister conceded that the 'flu epidemic has hit this country and it is too serious to be overshadowed by the lack of clarity and the confusion which has been the hallmark of the situation over the last few days.
Medical card holders, in the categories which Deputy Allen mentioned, must have this vaccine available to them and must not be expected to put their hands in their pockets to pay for their children or aged relatives.
People argued very strongly that no one should have to pay £15 for a rod licence but, when it comes to a matter of life and death, there are conflicting statements from the health boards, the Department and the Minister. In the conditions in the city at present, particularly in relation to the smog problem and the fact that the Minister has conceded that the worst epidemic in the last 13 to 15 years has hit Ireland, there is an obligation on him to ensure that there are adequate supplies of vaccine for the categories mentioned by Deputy Allen and that no medical card holder will be obliged to pay for the necessary vaccine to protect their families.
It is very hard to deal with the points raised in five minutes but I will dispose of the £5 first. I did not mislead the House on Tuesday and I stand over everything I said. After Deputy Rabbitte drew my attention to the fact that charges were being levied, I communicated with the Eastern Health Board and the Southern Health Board — in which it was alleged this was happening — but neither of them was aware that patients were being charged. I did not receive correspondence from Deputy Rabbitte and my officials informed me that they have not received correspondence about the particular case but I will be glad to talk to him afterwards.
I assure the Minister that it was supplied.
It was not supplied to me or my officials and the Eastern Health Board are also unaware of it. I made it clear to the health boards that medical card holders should not be charged for the vaccine and that it should be made available to those at risk. I envy people like Deputy Allen who knew there would be a major epidemic this year because he and Senator O'Reilly are the only people who knew it.
I did not say that, the World Health Organisation said it.
The vaccine is prepared by manufacturers on the basis of the demand for the coming season and the number of doses supplied in this country was 125,000, the same as for the last ten years; 105,000 people had the vaccine in September or October, the appropriate time to avail of it. I am surprised at Deputy Lee, who is a doctor, telling us that vaccine is the answer to the 'flu when we are in the middle of the epidemic. We have gone past that stage now and the 'flu is managed in a totally different and common-sense way. A person who has the 'flu should go to bed and take paracetamol and a hot drink.
On a point of order——
The Deputy cannot make a point of order now.
It is not a question of mass vaccination and it was never recommended that this should be the case as an answer to the 'flu epidemic. The vaccine is not available because the manufactures, on the basis of the demands, decided that they would not make vaccine which they would hold until next year when there might be a different 'flu strain and they would have to throw the whole lot out. The manufacturers decide, on the basis of demand, and nobody can foretell the years in which there will be a 'flu epidemic. We are not surprised that there is an epidemic this year because, each year, we anticipate that there might be one. However, we do not go in for a mass vaccination programme and neither does any other country. Vaccine is not in supply for any country in Europe at present, nevertheless, we succeeded in securing 20,000 extra doses of vaccine which will be available tomorrow. There will be 5,000 extra doses available at the beginning of next week, free of charge to people at risk, the elderly and those suffering from chronic illness, kidney disease and diabetes, chest and heart disease and so on.
Will there be sufficient?
There will be sufficient to meet the demand but there will not be enough to vaccinate everybody in the country. As I said, a person should have the vaccine in the autumn as it takes two to four weeks to develop any immunity.
In answer to the other questions raised by Deputy Allen, I assure the House that we are monitoring the situation and if beds are needed for victims of 'flu they will be supplied. Everyone who gets the 'flu does not need a hospital bed, which is the impression Deputy Allen gave.
Nobody said that.
The vast majority go to bed in their own homes, keep themselves warm and take paracetamol and a hot drink. As I said the 25,000 doses of vaccine available will be used for priority cases and there will be no charge.