We have one Report Stage amendment. I remind Senators that they may only speak once on Report Stage and that each amendment must be seconded.
Health (Amendment) Bill 2005: Report and Final Stages.
I move amendment No. 1:
In page 3, line 17, after "spouse," to insert "unless they be separated for more than five years,".
I will not delay the House as I already raised my concerns about this on Committee Stage. It is quite common here that people who parted after a very short time of marriage did not get a divorce because there was no divorce in this country. We must also take into account that some people do not want to get divorced for religious reasons. This has not been taken into account in this legislation as far as I can see. I suggest that one of the partners could be very unfairly treated in later life. He or she could be expected to pay up for minding someone whom they had, perhaps, not seen for 20 or 30 years. I doubt that those who framed the legislation intended this, but it could happen as a result of the way this legislation is framed. My best suggestion is to insert this amendment to say "unless they be separated for more than five years". This would prevent people from trying once again to get largesse from the State.
There seems to be an idea here that people are always planning ahead to get money from the State to which they are not entitled. If it is not lone parents, it must be old people who are going into nursing homes. It is rather shabby to think these groups are the sort of people who are trying to defraud the State. We can be quite sure they are some of the poorest in the State and those most in need of help. I foresee this causing trouble down the line. I do not know how many people it will affect but it is unfair. I doubt that whoever framed the legislation intended anything like this to happen.
The reason we are in the Oireachtas is to examine legislation. This amendment can hardly be described as anti-Government. We are trying to ensure that some people who may not be very well off will not be put in the position of trying to maintain someone with whom they have had little to do for a long time.
I second the amendment.
This is a matter that arose on Second Stage on which we sought legal opinion and which we discussed with the Tánaiste. The term "spouse" is included in the 1970 Act. It is only right that people's individual circumstances are taken into consideration in making a decision. This provision only applies to the medical card.
We must have regard to a person's overall financial situation. There is flexibility in this that has worked. I have not come across a situation where if a couple has been separated for a long period and there has been no communication, but where one partner is in a strong financial position, that has weakened the case of the other making an application for a medical card. We have examined this issue. There is no such thing as a perfect system, but we think this is the fairest we can have. We sought legal advice at the highest level and are quite happy to have this provision. Therefore, I cannot accept the amendment.
If the Minister of State has legal advice, I hope it is right. I also hope that if it is right, it is taken. We have had a lot of trouble over legal advice that was or was not taken recently. I hate to see legislation being passed that I think will put some people in a difficult situation in the future. These people are the very ones who will not be in a position to take legal advice because it is too expensive. In the case of the nursing homes, it was those who had the wherewithal to take legal advice who eventually exposed the situation. I can see that I will not get anywhere with this amendment and am disappointed.
The operational guidelines will allow a wide range of individual circumstances to be taken into consideration before a decision is made. Therefore, we should not be unduly worried with what we are putting in here. It is the fairest and most equitable way to proceed.
Amendment put and declared lost.
Bill received for final consideration.
Question proposed: "That the Bill do now pass."
I thank the Minister of State for his time and consideration. I hope my fears about this do not come to pass. The doctor-only medical card could be useful because it might decrease our reliance on pharmaceuticals. This is a double-edged sword because we rely so heavily on the pharmaceutical industry for employment that we pay some of the highest prices in Europe for pharmaceutical products. This is something the Minister should examine. The cost of medicines in Ireland compared with Italy, France and so on — I have not recently bought them in the United Kingdom — should be examined because the Government negotiates the price of pharmaceuticals with the companies. I have never found Ireland to be cheaper than other countries. For example, 11% of the health service budget is expended on such products. This must be examined considering €2 billion must be found somewhere.
I thank the Minister of State and his officials for their courtesy. Unfortunately, we have a great deal of experience of Health (Amendment) Bills in the House. It is amusing that the Government tabled an early signature motion on the legislation. I hope the President signs it into law, as requested. I also hope we have learned from past mistakes as it is depressing that the people have given up on the health service because they feel nobody can sort it out. That is a bad reflection on all of us and does not serve politics well. It is in everyone's interest that we should have a good and vibrant health service.
I hope the legislation will address a number of anomalies. It is regrettable that the Government is pressing ahead with the doctor-only medical cards on a long-term basis. That was not proposed in the programme for Government nor in election manifestos of the Government parties. They made a commitment to issue 200,000 extra traditional medical cards. The electorate has been short-changed and will realise that over time. It is also regrettable that our amendment was not accepted. The Government should extend the doctor-only medical card eligibility to include optical and dental benefits and examination fees because even that would be more acceptable. People can offset pharmacy charges through the drugs refund scheme but the Minister should prioritise families with young children for medical cards.
I am not fully confident the Government's approach to supply everybody over the age of 70 years with a medical card is sound. The Government is more into gimmicks and spin than substance and it has been found wanting on recent occasions. I thank the Minister of State for his help on the legislation. I hope the issues raised will ensure the provision of a proper health service.
I thank the Minister of State and Members for their contributions to the debate, which was worthwhile. The debate brings to mind the value of both Houses and the Presidency because legislation was considered and sifted. It highlighted the worth of our institutions of State. Even with the best will in the world in both Houses, a hiatus can occur from time to time.
I strongly support the repayment of moneys to those why were unjustly charged and I hope the people who garner the money are entitled to it and that those who are unworthy do not come out of the woodwork to claim money. They are the exception, not the rule but they exist and I have encountered a number of them. I thank the Minister of State, the Department and the Tánaiste, who has charted her ship through difficult waters.
I thank the Minister of State and his staff for their dealings with us but I still have many problems with the legislation, even though it is better than the Bill brought before the House prior to Christmas. Senator Glynn referred to the worth of both Houses but we passed an unconstitutional Bill before Christmas and our hands should be slapped.
It was not the first time and it will not be the last.
I stated during the debate on the previous legislation it was unconstitutional and when passed, it was referred by the President to the Supreme Court.
It is too much to expect an elderly person to hand over 80% of his or her pension. Elderly people should retain a greater share of their pensions so that they can have a good quality of life and engage in activities we take for granted. If I attend hospital, I am charged but money is not deducted at source from my income without my consent. Elderly people should be given their pensions and then charged for the service, the same as everybody else in society. How can the elderly not be trusted to pay their bills?
Senator Glynn praised the Minister and the Travers report. Her response was to point fingers and refer to vulnerable older people who were affected. However, the worst act was the attempt to abolish people's property rights. People had a right to compensation for the money illegally taken from them over the years and the Minister knowingly tried to prevent them for pursuing their entitlement to the compensation. That was found unconstitutional. That is the most wrongful act of all. The constant reference to maladministration is an attempt by the Minister and the Government to deflect from the wrongful act they committed prior to Christmas. The Minister knew what she was doing and there was no fudging on the issue. She knew she was taking away the right to claim compensation.
Senator Glynn referred to people coming out of the woodwork. The Minister thought she was doing nothing wrong by removing people's right to compensation but she tried to do the same under the Personal Injuries Assessment Board legislation, which was also found unconstitutional. Senator Henry referred to the notion of people on the make. People have legal rights and we should not take them away. They have a right to compensation when money is taken illegally and when they have suffered as a result of the acts of others. The Minister's philosophy is to take away those rights. Everybody sits back and says it is all right. I am a qualified solicitor and people have a right to compensation, which should not be abolished.
Many issues need to be examined. I read a study on nursing home subvention. More money should be invested in community care because many people need to go into nursing homes.
I thank Members for their contributions and assistance in passing the legislation. Senator Henry referred to the cost of drugs, on which a significant percentage of our budget is expended annually. That could be the subject of a good debate in the House in the future.
Regarding the treatment of the elderly, a mistake was made, and we will ensure that those who are entitled to a refund are paid as quickly as possible. We are finalising a scheme that will be announced shortly. We have already invited those who think they are entitled to a refund to log their names with us, and we will be in contact with them as soon as details of the scheme are available, which will be very shortly. We must rectify a wrong that was done, and we will be quite happy to do so. We assure people that it will be done as quickly as possible. The system we hope to put in place will be as transparent as possible, and no legal assistance will be required for people entitled to a refund; it will be paid as quickly as possible.
Senator Browne mentioned medical cards. The reason so many people are not qualifying is that incomes for thousands of families throughout the country have substantially increased as a result of how the economy has grown. That is the main reason people no longer qualify for medical cards. As Senator Henry said, the new doctor-only card is a very innovative initiative that will make a big difference everywhere. Its operation will be reviewed but it is an excellent idea worthy of support. I thank Members for their support for it today.
I thank the staff from the Department for their assistance. It has obviously not been an easy time for them over the past few weeks, but I very much appreciate their assistance and support to me since I took up office last September. I look forward to working with them in the months and years ahead.
Would it be in order to wish the Minister of State's brother good luck in the by-election tomorrow? Perhaps we will have the two Powers in the Dáil next Monday.
I hope not.
Question put and agreed to.