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Dáil Éireann debate -
Thursday, 5 Jun 2014

Vol. 843 No. 2

Leaders' Questions

The Minister for Finance, Deputy Noonan, announced here yesterday evening that some people who have lost their discretionary medical cards will now have them returned. It is still not clear whether all people will have them returned and the process for return has not been clarified. This is a particularly dramatic U-turn for this Government, particularly when its members all spent 18 months denying that a cull was under way. I notice the Minister, Deputy James Reilly, was not in the House when the announcement was made and he is not here now. However, since the announcement was made, there still continues to be Government disarray on the issue. The Minister of State, Deputy Alex White, who told us a few weeks ago that there was no such thing as a discretionary medical card, has said it is a collective Cabinet responsibility, for which he had no part, and now we read reports in all of today's newspapers regarding last night's Fine Gael Parliamentary Party meeting where the Minister, Deputy Reilly, told the meeting that the handling of medical cards was a disaster. He further told those present that he sought repeatedly to address the medical card issue but apparently the political will from his Cabinet colleagues was not there until last week. We now have the Minister, Deputy Reilly, and the Minister of State, Deputy White, who are the Laurel and Hardy of this Government, passing the buck rather than taking responsibility for the whole fiasco.

The fiasco is outlined in this morning's edition of The Irish Times in its coverage of the case of a family in Wicklow where a father has a rare cancer and a son has cerebral palsy and the family have been asked once again to resubmit documentation in regard to their medical card, a case that has been repeated hundreds, if not thousands, of times across the country as a direct result of the handling of this issue by the Minister, Deputy Reilly, and the Minister of State, Deputy White. This is only one case and the Minister and Minister of State are blaming someone else, and that someone else is the Minister, Deputy Howlin. All of the Fine Gael sources today are saying the lack of political will goes back to his desk and that he seems to be the person to whom the Minister, Deputy Reilly, is referring in regard to his inability to get buy-in to the solution of this problem.

A question please, Deputy.

Can the Minister outline his response to the suggestion, which has been made off the record, that he is the block to a resolution? Second, with this debacle in mind, and granted that he has an overseeing role in the Department of Health, can he express full confidence in the Minister, Deputy Reilly's ability to continue his job as Minister for Health?

The opening premise of the Deputy's question is wrong. There has been no cull or no intention of having a cull of medical cards.

It is ongoing.

Please, Deputies.

A Cheann Comhairle, that is hard to take.

The number of medical cards is at an all time high.

The stabilisers were put on-----

Quiet, please.

This is an extremely serious matter. At the end of last year, there was 1.849 million medical cards; 42% of the population have medical cards. There are more medical cards in circulation now than at any time in our history.

That is cold comfort.

I am a former Minister for Health. Every Administration has issued medical cards on the basis of the 1970 Act. It was done on a local basis determined by ability to meet medical costs. There was always a local discretion. Medical cards have been centralised in recent times. That was a decision made by the previous Administration that has been carried out. One of the things that has come to light in that is the variety in terms of the exercise of that discretion. For example, in Cork 70% over the national average in terms of medical cards were given and in Meath 70% under the national average were given. That is not equitable or fair. We need to have a system that takes account of real hardship, that is compassionate and that understands that such cases, and Deputy Calleary has instanced another one today, are unacceptable and that people who are faced with that sort of medical need should be assisted by the State. That is why the Cabinet has decided to develop a policy framework to determine eligibility in a fair and open way-----

-----not on the basis of where one lives in the State, which has been the condition for the past number of decades, but on objective criteria. The criteria, however, must also be linked to some financial grounding because that is the basis of the 1970 Act, or we can have a broader debate about looking at how we can afford to ensure that everybody who is sick gets comprehensive medical care for free.

Sending all the applications to Cork seems to be a good solution.

That is an extraordinary response from the Minister. The Cabinet, according to the Minister, Deputy Noonan, had a long discussion on medical cards - as did all of the Members' parliamentary parties. Some 16,000 discretionary medical cards were cut from January 2013 to April 2014. That is a cull in any language. Those are discretionary cards taken from people in the case I described, taken from children with disabilities or families coping with serious illnesses and being asked to go through the rigamarole. Again, the Minister avoided the direct question I put to him. He has answered the other question because I judge from his attitude that he may be the block to some sort of justifiable resolution to this issue. Does he have confidence in the Minister, Deputy James Reilly's ability to continue as Minister for Health? A straight "Yes" or "No" answer will suffice; there is no need for a soliloquy.

A "Yes" or "No" answer now, Minister.

First, I have full confidence in the Minister, Deputy James Reilly, and every member of this Government and I have full confidence in every Minister of State to do the job, the most difficult, challenging job that faces us all. Every Department has been faced with very difficult economic decisions to make. This Government has worked as a collective-----

It does not look like it.

-----to solve the issues to bring us from a very difficult position to a position of solvency, which we have now arrived at. We have tried to do that and have done that in as compassionate and open a way as we can. Have we made mistakes? Yes, and I agree with Deputy Calleary that the handling in terms of the administration and some of the letters people got is unacceptable. It is unacceptable to every member of Government and we need to do better. If one looks at discretionary medical cards and the general review of medical cards, there is a normal turnover. One could instance thousands being changed. Out of 1.8 million, naturally people's circumstances change and there are people who losing medical cards and new people gaining them. What we have to do is to have an objective system that works wherever one lives in the country, that is compassionate and that takes account not only of financial means, but also of health criteria.

That is what we had before.

That is what is being developed now by the Department of Health and by the Minister for Health and he is going to come back to Government within the next fortnight with those criteria so that we can put in a rational, compassionate, national scheme that is not determined by where one lives in this country, but on the real medical demands upon every household.

News that the remains of some 800 babies have been found on convent grounds in Tuam has shocked the people of Ireland. Only for the efforts of a local historian, Catherine Corless, these children would forever remain nameless in the ground, forgotten in death as they were in life. This scandal of neglect and maltreatment causing the deaths of children has understandably made headlines across the world. Unfortunately and tragically, Tuam is not an isolated case. Dozens of these homes were in operation in Ireland from the late 1880s well into the 20th century.

We simply do not know how many of these mass graves might exist. Church and State cannot be allowed to abdicate responsibility in this matter. The Government must face up to this shameful period of our recent history and shine a light on the dark secrets of mother and baby homes. Citizens need to know who died and why, and the locations of their remains.

Will the Government initiate a full audit of the 25,000 files currently in the possession of the Health Service Executive? We need to know how many concern illegal adoptions, who was responsible, who knew about what was happening, and what they did or did not do. What is needed now is a full public inquiry into practices at all mother and baby homes across the State. It is time to shed light on what led to the shocking infant mortality rates, the burial of untold hundreds of babies in mass graves, and the routine illegal adoption and trafficking of an unknown number of the surviving children. Can the Minister tell us today whether the Government will initiate a full public inquiry into the practices at mother and baby homes across the State?

Like every Member of this House and every citizen in the country, I thought we had become inured to the things that fall out of our dark past. However, the discovery of a mass grave of infants and children is something so shocking that it jars all of us to our core. The Government is determined to get to the bottom of what exactly is the situation in Tuam. All the questions the Deputy asked must be answered not only in regard to Tuam, but also the other centres. For that reason, we have established an interdepartmental group which has already begun to meet and will report back to Government as quickly as is practicable and possible, but certainly no later than the end of this month, on how we should proceed. This Government is ruling out nothing in terms of what needs to be done. The sense almost of revulsion of the people of Ireland at the callous disregard for the most innocent of our young people has to be met with openness and clarity, which is what the Government will do.

Citizens have been confronted in recent years with one revelation after another regarding the abuse of people in religious-run institutions that were supported by this State. The scale of the abuse perpetrated against Irish women and children that has been exposed by these cases is absolutely horrific. In order to get to the truth of these scandals, it was necessary to have the Commission to Inquire into Child Abuse, generally known as the Ryan commission, whose report was published in 2009, the Ferns inquiry, the Cloyne report and the Murphy report. We also had the scandal of the Magdalen laundries. The State is still failing to face up to its responsibilities in regard to the Bethany Home or to apologise to its victims. If we were to have adopted the approach the Government is now advocating in regard to the Tuam babies scandal, the various inquiries and reports to which I referred would not have seen the light of day. Is it not crystal clear, therefore, that a full public inquiry is the only conceivable course of action when confronted with the gravity of the scandal that has now come to light in Tuam?

The Deputy clearly prepared her second question before she heard my answer to the first one.

The Minister did not indicate in his reply whether the Government will initiate a full public inquiry. That is the question I asked.

We need to get to the bottom of all these issues. In the early decades of this State, attitudes towards women, particularly unmarried women, and to the most vulnerable in our society revealed again and again a shocking litany of disregard for citizens. This Government was the first, after decades, to deal with the case of the Magdalen laundry women, and I am proud of our record in addressing it. We will address this issue, too. We will address it in a comprehensive way, because it is not, as the Deputy rightly says, confined to Tuam. We need to scope out exactly what questions must be answered. We are working at this time on the records; there has been no excavation and we do not yet know what is in those graves in Tuam. We need to scope out, in a comprehensive way, what exactly needs to be examined, and that is what the interdepartmental group is doing. Its report will come to Government in a matter of weeks. It has taken decades for our country to get to the level of maturity where we look back now in shock at what happened in the past. We will have to reveal the truth about those dark days with clarity and purpose, and that is what the Government will do.

I wish to raise the same issue. Like everybody else, since the news broke last week I cannot get the image out of my head of 800 tiny babies and helpless children neglected, starved and eventually discarded. I respect and acknowledge the endeavours of Catherine Corless and her committee, who initially sought to erect a memorial to the children they knew had died in the home. The extent of what they discovered, however, was way beyond what was expected and now requires so much more than a memorial or indeed an apology.

Today, finally, the atrocity is being openly discussed in the national media, but I am concerned about the sanitised language that is being used when discussing it. We are hearing references to "burials" when, in fact, we are talking about bodies being disposed of in a septic tank. The discovery in the 1970s by two boys revealed the nature of the disposal of the remains. Clearly, these were not respectful burials - they were disposals, as though these children were subhuman. It is stomach-churning. The UN pulled no punches recently when it described the Magdalen laundries as places of forced labour, with slavery-like conditions. There appears to be a type of reluctant acceptance of the reality of what happened here, but the UN was able to call it what it was. We need to call it what it is in this instance and that requires clarity.

Tuam was not the only mother and baby home where this type of thing happened. We already know about the Bessborough case, for example, where there were horrific stories about the mortality rates. This morning, there were repeated references in the media to what the Archbishop had to say about the Tuam revelations. I have more interest at this time in hearing what the Minister for Justice and Equality and the Garda Commissioner have to say about it. I agree with Deputy McLellan that a public inquiry is needed, and there must be an immediate acknowledgement of that from the Government. Will the Minister commit to holding such an inquiry? Does he agree that the nature of the disposal of the bodies suggests that the intention was that their disposal remain a secret? One has to ask why that would be the case. If this septic tank was discovered anywhere else in the country other than beside a religious institution, it would already have been declared a crime scene. It begs the question of why, in fact, it has not been declared as such, which it should and must be.

I agree with much of what the Deputy has said. Characterising these children as being discarded is an accurate characterisation which goes to the attitude the State had over those decades to the children of unmarried mothers. It is shocking, unacceptable and appalling, and we have to meet that in our time, as we have met other awfulness from our past. Speaking on behalf of the Government, I am ruling nothing out as to how we should proceed. We are scoping out how far this went. Whether there are other locations we need to look at needs to be determined, as well as what records exist within the HSE or religious institutions. We will scope this out in the coming weeks and come back to the House with a proposal. We will then have a proper cross-party debate, as we all want, in order to have the full truth exposed in regard to these apparently horrific events which scar our past.

An interdepartmental scoping exercise is fine, but it has to happen in parallel with this discovery being designated a crime scene. We know that in previous cases involving mother and baby homes, drug trials took place in some instances. Did that happen in this location? Such questions need to be part of the inquiry. Could such trials have accounted for the very high mortality rates? The persons who ran the homes clearly treated the women and children there as subhuman. Not to deal with this case in an equal manner to those of other unearthed human remains reaffirms that status posthumously. No Department and no set of paper records can reveal what the Garda, the State Pathologist or forensic anthropologists can reveal.

They can tell us if crimes were committed at this scene. It is possible to fully understand and to know what went on here but for that to happen, the authorities must do what they did not do before. They must act. Could drug trials have contributed to the high death rates here? Is it known if inquests were held into these deaths? What exactly is the Government inquiring into? What Departments are involved? Will the Minister declare this, or seek to have this declared, a crime scene?

It is not for me to declare a crime scene. That is a matter for the Garda Síochána, the independent investigator of crime in this country. All the data need to be looked at and that is what we are determined to do in a comprehensive way, as I have indicated to the House. The interdepartmental group is meeting. A range of Departments are involved, including the Department of Children and Youth Affairs, the Department of Health and the Department of Justice and Equality. There may be other Departments involved and I will get a full list of the membership to the Deputy. We do not want to embark on a process that is not comprehensive and will leave things out.

These things are decades in the making. This awfulness happened many decades ago but we will now, in our time, have a comprehensive look at what happened, reveal as much truth as we can from what lies within any official records and have such inquiries as are appropriate, including criminal inquiries if that is deemed appropriate by the Garda authorities, the investigators of crime.

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