When I reported progress before Question Time I was drawing the attention of the House to the cutback in the services provided by health boards in order to fit within the allocation by the Government. I was highlighting the frustration this cutback was causing not alone to the health boards concerned but also to the general public. I shall relate my remarks to the Western Health Board area where we have a number of institutions which have been unable to open during the current financial year because of the cutback in money. One which immediately springs to mind is the St. Francis Home at Newcastle, County Galway. This home was built at a cost of £180,000, is fully furnished and a matron has been appointed for the past few months. Up to now, because the Minister for Health was not prepared to make the necessary money available to the health board for the running of this home, it has been lying idle even though there is a very great demand for this kind of home in the western region.
I am glad to say that because of the efforts of some local volunteers it has now been found possible to open this home and the official opening is to take place on 29th June. I would like to compliment the people who are volunteering their services free of charge. I wish them every success in their undertaking. It was a cause of great concern to everybody to see this home lying idle with such great need for it. It is hoped before the end of the year that it will be working to full capacity.
We also have a psychiatric unit and an intensive care unit in Galway Regional Hospital. The same position obtains; there is no money available to extend these services. We have a geriatric assessment unit at Merlin Park and a family guidance unit at Salthill which are also affected and, as far as I can see, there is no hope of opening any of these units during the coming financial year. This is a great worry to all of us. The estimates this year for the Western Health Board services amounted to £32 million and the board's allocation is short by about £2.6 million. They must try to work within their allocation and naturally it would not be possible to maintain services provided during 1975 and they have had to start cutting back drastically on those services.
I want to mention the Galway County Association for Mentally Handicapped Children. We appreciate the tremendous work this group are doing for mentally handicapped in our area. The group represents 24 branches throughout the county. They are in a very serious financial position and for the end of the year they have a projected deficit of about £66,457, a very high figure for any organisation to try to meet. They have tried their best to secure funds from voluntary subscribers by organising collections and so on and the Western Health Board made contributions to the association over the past two years. This year the health board, because of the restraint imposed on them, cannot give all the assistance they would like to give and, accordingly, the health board's contribution has been cut back. In 1974 the health board agreed to pay the association £27,000. They actually paid £15,000, a shortfall of £12,000. In 1975, the health board agreed to pay £28,000. They paid £20,000 leaving a shortfall of £8,000, making a total shortfall of £20,000.
It should be the responsibility of the State to provide sufficient money to ensure that handicapped children, the most disadvantaged section of the community, would be provided with adequate care and attention. It is not right that voluntary associations that are doing such great work to help those children and their parents to overcome their terrible cross should be expected to go out to church gates and collect funds to provide services or keep existing services going. It is time the State came to their assistance. I am only speaking of the County Galway association but I would like to list some of the schools for which they are responsible and the number of children for whom they provide care. First, there is St. Joseph's School for Moderately Handicapped Children in Galway, accommodating 75 children. There is the Care and Activity Unit, Galway, for severely handicapped children, where the number cared for is 22. We have St. Dympna's Centre, Portumna, for severely handicapped children, where eight children are accommodated. The Tuam Centre for severely handicapped children has 12 children and St. Joseph's Training Centre, Galway, which provides occupational training for school leavers has 20, making a total of 137 children.
Those people are to be congratulated on the efforts they have made to provide services for those children. They have tried to extend those services to other areas such as Carraroe and Glenamaddy. A deputation from the north-east Galway area which includes Glenamaddy, Mount Bellew and other areas, met departmental officials recently in an effort to get funds to open a school near Kilkerrin, Ballinasloe which has been offered by His Grace, the Archbishop of Tuam. I ask the Minister to take a very sympathetic view of the proposals put before him by the deputation which met his officials some weeks ago and, if possible, ensure that the service sought is provided.
We are fortunate in having so many dedicated and enthusiastic people providing care and treatment for our mentally handicapped but the State should play a greater part in providing money to ensure the efficient running of the services required.
One issue that confronts every public representative whether or not he is a member of a health board is the question of medical cards. In the past few months we have seen efforts made by the board to curtail the number of cards issued. I do not agree with these efforts and I do not agree with the method of assessing people's means in connection with their applications for medical cards. I am not sure if this applies to other areas but we found in the Western Health Board area that farmers have to supply warble fly certificates or blue card certificates to health board officials to show the numbers of stock they have at the time of application. On this basis their entitlement to a medical card is decided. This system is very unfair because there is great variation in the price, the type, the weight and the age of cattle and, to my mind, having to produce warble fly certificates for all stock on a farmer's land at a given time is entirely wrong. This system should be scrapped. Not alone is it encouraging farmers not to have their cattle dressed properly for the elimination of warbles, but because of the variation in prices at different times of the year it is a wrong system for deciding entitlement to a medical card
We know that the loss of a medical card is of great concern to people because of increased hospital charges and the increased cost of drugs. People are worried about the possibility of having to go into hospital and not being able to pay their hospital charges. The amount of social welfare a farmer is in receipt of is taken into consideration in assessing his eligibility for a medical card. Two reasons given for refusing medical cards are social welfare benefits and farm income. Again, this is very unreasonable. There is no point in the Government boasting about the payments they make to social welfare recipients if those social welfare payments are helping to deprive people of medical cards. When a person is entitled to unemployment benefit he should automatically be entitled to a medical card.
Another matter which causes concern is the availability of doctors at weekends. There is no point in the Minister telling this House of the improvement that has taken place in the health service when a sick person cannot get a doctor. We have seen the recent controversy in Dublin over the child who could not get a doctor and was dead on admission to hospital. We could all instance similar cases in our own constituencies of people who had to make four or five calls to try to get doctors to come out during the night. The Department and the health boards may say that doctors have no responsibility other than to people who are the holders of medical cards, but I think there is something radically wrong with our health service when a person cannot be guaranteed the treatment he requires as fast as possible, whether he is a medical card holder or not. We should aim towards that kind of service.
In regard to the availability of doctors at weekends, we should encourage group practice. This has been suggested by other speakers and I have suggested it before when speaking on the Health Estimate. In the west of Ireland, particularly, doctors find it hard to get locums. We realise that doctors cannot be expected to work 24 hours a day, but I think the development of group practice would be an answer to the problem.
One must view with great concern the recent report of the working party on the rising costs of medicines and the pattern of prescribing. One statistic which emerged from that report is that 65 per cent of the total cost of the choice of doctor scheme results from the supply of medicines and appliances. This aspect of the report should be examined very closely to ascertain whether there is overpre-scribing of expensive drugs. How many of those expensive drugs are being used by the patients concerned? Quite an amount of expensive drugs are wasted by patients. It is true to say that expensive drugs are left lying around in many houses. They are useless to the patient and a danger to people who might take them in error. People should be encouraged to return unfinished drugs to a doctor or public health nurse because the cost of drugs is one of the reasons for the cancellation of medical cards. We are slowly creating in Ireland a situation where the cost of being sick is the cause of illness for many. Perhaps there is some merit in the Swedish scheme mentioned by Deputy Dr. O'Connell. Under this scheme essential drugs are free and a contribution is made towards the cost of nonessential drugs.
In conclusion, I should like to ask the Minister to impress on his colleagues the importance of providing an adequate health service for our people. We now know that the health service for 1976 cannot be maintained at the 1975 level. This is to be regretted. The Government must accept responsibility for this situation, which is due to their inability to generate sufficient wealth to enable health boards to provide the service to which the people are entitled. I hope the Minister and his colleagues will do everything possible to provide that the health service is improved as quickly as possible.