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Seanad Éireann debate -
Thursday, 27 Oct 2011

Vol. 211 No. 3

Adjournment Matters

Medical Cards

I appreciate the Minister is under time pressure. My question is one I could have placed by way of parliamentary question if there was such a facility in the Seanad but unfortunately there is not.

I raise the issues of medical cards, the financial guidelines in place and the deductions allowable, with particular reference to those who suffer from Alzheimer's disease. I appreciate the disease is becoming more prevalent and affects thousands of people nationally. Although a medical service of a good standard is available to most sufferers and the Minister and his officials are planning further developments in this regard, I have been approached recently by a number of constituents with family members who suffer from the disease and who are ineligible for a medical card because of the income limit. One case, about which I have not yet written but which I am sure will be appealed, concerns a constituent whose mother, who is in her mid-70s, has been refused a medical card on financial grounds. I appreciate that the income limit of €35,000 per annum for those over 70 is generous but, in this case, the family must pay €3,000 per month for care and help in the house for the mother.

A number of deductions can be made in the case of people under 70. Expenses such as child care expenses, mortgages and the cost of travelling to work, and so on, are taken into account but no such considerations apply to those over 70. Where home care for almost 24 hours per day is required, there should be a reduction in the income limit in the calculation of medical card eligibility. I ask the Minister to review the financial guidelines, in particular the deductions that could apply to persons over 70. I make the case for sufferers from Alzheimer's disease in particular because of the high level of care required. I look forward to the Minister's response. I am sure this is a matter we can discuss in more detail in the future.

I thank the Senator for his inquiry. I will explain how the Health Service Executive assesses eligibility for a medical card and takes account of one's circumstances. Eligibility criteria for health services are set out in the Health Act 1970, as amended. In accordance with the legislation, eligibility is primarily determined by reference to a person's residence and means. Ordinarily, residents in the State are entitled to full eligibility or limited eligibility for public services. Full eligibility is determined by reference to section 45 of the Health Act 1970, as amended. Section 45(1) provides that persons who, in the opinion of the HSE, are unable, without undue hardship, to arrange general practitioner medical services for themselves and their dependants shall have full eligibility. Persons with full eligibility and their dependants are awarded a medical card by the HSE.

Under the Health Act 2004, the HSE is responsible for assessing a person's entitlement to a medical card. All medical card applications are assessed against the criteria set out in the HSE's national assessment guidelines for medical cards. Section 45(2) of the Act provides that, in deciding whether a person should have full eligibility, the HSE shall have regard to the person's overall financial circumstances in view of his or her reasonable expenditure in regard to himself, herself or his or her dependants. Therefore, medical cards are granted primarily on the basis of a person's means and individual circumstances. As such, all people seeking a medical card must be assessed under the undue hardship principle. The HSE has discretion in cases of exceptional need to provide assistance to individuals who do not qualify for full eligibility under the national assessment guidelines but where undue hardship would otherwise be caused if they were not awarded a medical card.

In view of the legislation, there are no plans to grant medical cards in respect of particular groups. I take issue with that and do not believe we can allow circumstances to obtain in which we do not look after people with particular needs. That is not to say specific groups, such as those with Alzheimer's disease, can be looked after in the immediate future, but I have said we are considering the circumstances of special groups and would like to be able to do something in this regard. We are caught between a rock and a hard place with regard to money. I am sure the Senator already knows there was a €70 million overrun at the beginning of the year, and a three month overrun in the hospitals. The budget has decreased by €1 billion. We are, therefore, not in a position to do what we would like to do as quickly we would like, but we will extend the medical card next year to those on long-term illness cards. Specific groups, including those with diabetes, will be looked after in that regard. The main benchmark is income guidelines.

A group of doctors, comprising the PCRS, has been appointed within the HSE to consider discretionary medical cards. The case to which the Senator alluded will be referred to it for adjudication. I hope it will make the decision the Senator seeks. In the past, discretion lay with the CEO of the health board, but this post no longer exists. The PCRS will take on that function. I have asked it to consider, in particular, those with terminal illnesses and other groups such as those mentioned by the Senator.

I thank the Minister. This is the first time in my many years in the Oireachtas that a Minister more or less ignored his script and, fortunately, went off message.

Redundancy Payments

That is a first for me also. It is nice to see the Minister going off script. This is what Senator Crown referred to when he spoke of leadership as opposed to management.

My query relates to the processing time of redundancy payments and the steps the Department will take to ensure it is shortened. There has been a transfer of responsibility to the Department of Social Protection. The call centre is being staffed by the people processing the claims. We tried to make a number of calls to it every day for a week but only received an answer once. This has nothing to do with the staff but is because they do not have time to answer the telephone and process the claims. We have been told they are now dealing with the claims that arrived in April, which means they will be dealing with the October claims next year. This is obviously causing severe hardship.

The Minister is familiar with the cystic fibrosis issue in the unit in Cork because he met Build4Life and realises the provision of €300,000 would allow the €2.3 million project to go ahead. The return to the taxpayer would be €450,000. These are my figures and I would appreciate the Minister's views thereon.

With regard to mental health, 1,200 nurses are due to retire in February, thereby causing a problem. The Minister is aware of this. What does he hope to do about it? Capital funding for mental health services is due to come from the sale of old institutions. We are all aware that there is no market any more and that there is no provision in this regard. Will the Minister clarify how the investment will be funded? How will A Vision for Change be funded? There are many recommendations therein.

On a lighter note, I invite the Minister down to Kenmare to open the hospital, before 2012 or in 2012 or 2013, or whenever his schedule allows. He will be informing his constituency colleagues. We would all like to welcome him down to An Neidín for the opening of the hospital, the campaign for which started in 1974. I welcome the Minister to the House.

The Senator should forgive me if I address the question put rather than the numerous ones he just raised. Senator Sheahan and Deputy Griffin have been extending invitations to me regularly to open the hospital. I will be very happy to do so at the appropriate time.

The issue the Senator raised is very serious, particularly at a time of economic crisis in which many have been made redundant. We take it very seriously. Six months is a frightening length of time to wait when one's financial circumstances are in doubt and one's world is upside down on having lost one's job. I thank the Senator for affording to me the opportunity to provide clarification on the processing of redundancy payments and the steps I am taking to improve the service being provided. On 1 January 2011, responsibility for administering the redundancy payments scheme was transferred to the Department of Social Protection from the Department of Enterprise, Trade and Innovation. The purpose of the scheme is to compensate workers under the Redundancy Payments Act for the loss of their jobs through redundancy.

Compensation is based on the worker's length of reckonable service and reckonable weekly remuneration, subject to a ceiling of €600 per week. All payments are made from the social insurance fund.

There are two types of redundancy payment made from the social insurance fund, namely, rebates to those employers who have made statutory redundancy payments to eligible employees and statutory lump sums to employees whose employers are insolvent or in receivership or both or are in liquidation. It goes without saying the economic downturn has placed increasing demands on this service, as well as on many others within the remit of the Minister and mine, as the requirement for medical cards increases. In 2009 redundancy claims reached a peak of 77,000 from the previous norm of approximately 25,000 per year. In 2010 the levels remained high at 58,731 and this year it is likely there will still be in excess of 50,000 claims. In general, claims dating from April are being processed; therefore, the waiting time is approximately six months. The high level of claims has resulted in increased processing times, something the Minister is trying to address in a number of ways that I will now outline.

On 3 October a new redundancy payments processing system went live. This system is fully integrated with the Department's service delivery modernisation programme and the focus of the initiative is to streamline the redundancy claim process, thereby improving claim processing times. Part of the new system facilitates the scanning of both manual and online claims, which will be beneficial to the reduction of processing times. Online redundancy claims are also facilitated by this system. Substantial and frequent updates are provided on the Department's website to inform the public of system changes and advise them of processing times. In recent weeks customers have been gaining familiarity with a new web form design for submitting redundancy claims.

The Minister is planning to introduce an interactive voice response telephone answering system to stream telephone queries to dedicated teams. The staffing resources have been restructured in accordance with the modernisation programme. A specific team has been tasked with dealing with the backlog element of redundancy claims. The Department has also allocated some temporary additional staff to this area and the Minister intends to add more in the coming weeks, approximately five staff in total, equivalent to more than 25% of the staff currently assigned to processing payments, to tackle the processing of claims. Many other elements of change are being incorporated into this area of operation to maximise process improvements and improve customer service.

The Minister and I are acutely aware of the financial hardship faced by many households and it is my expectation the steps outlined will result in improved processing times which will alleviate many of the difficulties being faced by customers.

I acknowledge the Minister is aware of the issue. However, I am concerned that only five additional staff members have been allocated which, in essence, constitutes an increase of 25%. This is not a huge increase in the allocation.

Does the Senator have a question?

Will the Minister go back to his Cabinet colleague and ask for an increased allocation? The allocation of an additional five staff members to deal with the 50,000 claims in 2011 will not decrease the rate by a significant amount. There are staff members within the system who could be reallocated and I ask that more be done.

I agree that, on the face of it, five sounds like a very small number. However, as it constitutes an increase of 25%, I ask the Senator to await developments in the next couple of weeks to ascertain how this affects the service. If it does not have the desired result, I certainly will convey the Senator's concerns to the Minister for Social Protection, Deputy Joan Burton, who is particularly concerned about this issue. As the period coming up to Christmas will be a difficult one, the Government certainly does not wish to leave people feeling uncertain regarding their redundancy payments any longer than is necessary.

Garda Stations

I welcome the Minister of State, Deputy Kehoe.

I take the opportunity to raise a serious issue, namely, cuts to the Garda budget this year and beyond and the impact this might have on services to the people of Dublin North-East. Earlier this year we were privileged to have the visits to Ireland of President Obama and the Queen. I understand the policing aspects of these visits cost €35 million but the benefits for tourism and other sectors of the economy undoubtedly far outweigh the costs. At the time we were led to believe by the Government that additional funding would be provided for the Garda budget this year to avoid being obliged to make cuts to normal Garda services to cover the cost of the visits. This is entirely appropriate, given that there will be a net gain to the Exchequer overall from the visits and it is only right that money should be provided from other areas to ensure the preservation of policing strength this year.

In May the Minister for Justice and Equality, Deputy Alan Shatter, stated the Government was "anxious to ensure that the capacity of the Garda to provide a full and proper service ... would not be [in any way] impaired" by the cost of the State visits. However, almost five months later he has confirmed to the Dáil that there still is no agreement between himself and his colleague, the Minister for Public Expenditure and Reform, Deputy Brendan Howlin, on providing more money for the Garda budget. It is now the end of October and the year's end is approaching swiftly. At this late juncture one may suspect that funding will not be provided for the Garda to cover the costs of the State visits.

In response to a question in the Dáil last Tuesday from my colleague, Deputy Dara Calleary, Fianna Fáil's Front Bench spokesperson on justice, the Minister stated he had asked the Garda Commissioner to examine the possibility of making savings in future years to the Garda Síochána budget by cutting the opening hours of Garda stations and closing some stations nationwide. In recent weeks there have been worrying reports that the stations in Malahide and Howth are among those in line to get the chop from the Government. Were this to happen I would be extremely concerned, as would my colleague, Senator Darragh O'Brien, who looks after the Dublin North area. Malahide Garda station serves Portmarnock in Dublin North-East and Malahide and its hinterland in Dublin North. The Government had discussed previously — in fairness, its predecessor also had been given proposals — possible savings with regard to small rural stations. I refer to stations in which only one garda is based in an area and in which the community could be better served by having that garda out on the beat all the time, rather than being based in a building. However, far from being small stations, the station at Howth has 40 gardaí based in it, while 36 gardaí are based in the station at Malahide. In other words, these are huge stations serving busy urban areas. In conjunction with the Garda stations located at Raheny and Coolock, they provide an incredibly important service for the people of Dublin North-East.

Consequently, I have two issues on which I seek a response from the Minister of State, Deputy Kehoe, on behalf of his ministerial colleague. There is much concern about this issue in the area from which I come and people seek a clear and fair answer from the Government at this stage to learn what is being planned behind the scenes. First, will the Garda budget be afforded additional funding this year to meet the cost of the State visits and avoid essential front-line services being cut nationwide? Second, will the Minister of State and the Government rule out the closure of Malahide, Howth, Coolock and Raheny Garda stations? While Malahide and Howth Garda stations were mentioned in the media articles, one has no idea what other stations are being examined by the Government. The Minister of State should respond clearly on these two issues. All Members will agree that local Garda stations provide an incredibly important service for the community and even in the context of the recession, if one cuts money from such services now, one will end up paying for it in the long term.

The Minister for Justice and Equality and Defence, Deputy Alan Shatter, has asked me to thank the Senator for raising this matter, as it provides him with an opportunity to clarify the position on the important topic she has highlighted.

Before I continue, I know Members will join me, on behalf of the Minister, in again sending our deepest sympathy to the family, colleagues and friends of Garda Ciaran Jones who was swept away while helping members of the public in the most hazardous of conditions last Monday evening in County Wicklow. Our thoughts and prayers are with his family at this dreadful and sad time.

It is important to put in context the matter raised by the Senator. Under plans agreed by the previous Government as part of its compliance with the terms of the EU-IMF agreement, Garda numbers are to be reduced to 13,500 by the end of this year and by a further 500 to 13,000 by 2014. However, what will ultimately determine the sustainable level of Garda numbers is the level of budgetary provision that can be made for the force in the coming years. Difficult decisions will have to be made right across the public sector to bring the public finances back into balance. This means the Garda Síochána, like every other public sector body, is going to have to manage with reduced resources. The Garda Commissioner is, therefore, reviewing all aspects of policing operations, including the deployment of personnel, the utilisation of modern technologies and the operation of Garda stations. No decision has been taken on the closure of any Garda station or a reduction of public opening hours in some stations. However, the Garda Commissioner will have to address these issues as part of the review. He may have to consider whether, in appropriate cases, a better policing service could be delivered to a local community by having Garda members out on patrol rather than in a station. The Minister will carefully consider the outcome of the review and the Garda Commissioner's policing plan for next year with the objective of ensuring priority is given to the maintenance of front-line Garda services at the highest level possible.

On behalf of the Minister, I pay tribute to the Garda Síochána at this particularly difficult time for the commitment and professionalism it displays in carrying out its duties, as exemplified recently by the selfless sacrifice made by Garda Ciaran Jones. The Minister is confident that the Garda will continue to maintain the confidence of the public and operate successfully, as it has been doing so effectively since the foundation of the State.

I note the Minister of State did not rule out the closure of Howth or Malahide Garda stations. Has the Government a list of Garda stations in north-east Dublin that it is considering for closure or downgrading? While I accept the Minister of State claims no final decision has been made, when it is, it will be too late for people in the area to make their dissatisfaction clear to the Government.

Will the Minister of State confirm if extra moneys will be given to the Garda to cover the cost of the State visits during the summer, as originally promised, so as to avoid cuts to front-line services?

The Department of Justice and Equality is in discussions with the Departments of Finance and Public Expenditure and Reform, with the Garda Commissioner, on dealing with the cost of the State visits. We are faced with difficult economic challenges, passed on to us by the previous Government, and money is not that freely available. However, the Minister for Justice and Equality, Deputy Alan Shatter, is following up on the issue of these costs.

As I stated, the Garda Commissioner and Garda management are reviewing policing operations. When the review is completed, the Minister will let both Houses know — he has stated he will leave no Member in the dark — when he has made a decision, unlike the previous Government which did not inform either Members or the public about decisions it had made to cut services or the reasons behind them.

The Seanad adjourned at 2.15 p.m. until 2.30 p.m. on Tuesday, 8 November 2011.