I express my sincere gratitude to the Chair for allowing me this motion on the Adjournment. With the permission of the House I seek to share my time with my colleague Deputy Nealon.
Adjournment Debate. - Medical Card Eligibility.
Is that agreed? Agreed.
I am delighted to see the Minister of State, Deputy Noel Treacy, in the House, because Deputy Treacy is first a junior Minister at the Department of Health and second a representative of a western constituency, so he is totally au fait with the problems encountered by farmers in general and particularly by farmers in the west. I know I am pushing an open door. I will make a number of salient, logical arguments that cry out for natural justice. Medical card guidelines were set down by the Minister in consultation with the eight health boards. At the best of times such guidelines are restrictive. We have established that somebody can qualify for a medical card provided his income is under £65 a week. There is an upward threshold for the adult dependant and a reduced upward threshold for each child dependant. It is however, a fairly restricted regime. To qualify, one must submit evidence of earnings. It is relatively simple for a person on the PAYE sector to produce a P60 or a P45. The self employed produce a profit and loss account. However, if one derives one's income exclusively from farming one is bound by the ridiculous notional system which, as the title suggests, is entirely notional and is based on the production of flat rate figures. Unfortunately, in this case it is based on criteria that are no longer valid. I respectfully submit that on the basis of the experience of farmers in County Wexford who in 1982 took the whole business of the constitutionality of the rateable valuation system to the courts and won, such a notional system could, if challenged in the courts, be declared illegal and unconstitutional. In the meantime we are stuck with the system.
The flat rate system of assessment for medical cards is based on the assumption that every animal yields exactly the same income. Whether that animal is in the west, the north or the south the assumption is that its yield will be exactly the same and give the same profit to the farmer. Of course that is manifestly untrue. The assumption is that if one has a bovine adult unit the animals, whether bullocks, heifers or cows, will yield a profit of £120. It is assumed that every calf yields a flat rate net profit of £50 and that every sheep or lamb will yield on an annual basis a profit of £40. That may have been the position a number of years ago or, indeed, some months ago but it is now well established that the bottom has fallen out of agricultural prices. The Minister of State, a Deputy from the west of Ireland who has in the recent past been involved in the livestock trade, will be aware that cattle are fetching almost £100 per head less than they did this time last year. He will be aware that lamb prices in Galway-East, Mayo-East and Sligo-Leitrim are between £20 and £40 per head less than this time last year. The Minister of State will be aware that one cannot give wool away because the price is so low. This time last year milk prices were in the region of £1 per gallon but today top grade milk fetches in the region of 80p per gallon and lower grade milk 78p per gallon. They are indications of the dramatic fall in farm incomes.
The guidelines for medical cards, which are based on notional assessments of income, and in accordance with established criteria agreed in conjunction with Teagasc, should now, in the light of the overwhelming evidence that farm incomes have dropped dramatically, be downwardly adjusted to take cognisance of that fall. Urgent talks should be undertaken with Teagasc, the IFA, the ICMSA and other interested bodies in an effort to reach a consensus on the downward movement of thresholds and in order to give fair play. People are losing medical cards at an enormous rate on the basis of such assessments.
I should like to express my thanks to Deputy Higgins for giving me some of his time. Generally farms are small and some land very bad and a substantial number of farmers in Sligo, Mayo, Leitrim and Roscommon and, indeed, in parts of Galway, receive unemployment assistance or what is known locally as small farmers' dole and qualify also for medical cards. There is no dispute about the principle of dole for small farmers or medical cards for them. What is at issue is the level of the estimates being made by the Departments of Health and Social Welfare of family farm incomes as distinct from the reality that exists behind the farm gate. Most of all we are concerned about the disastrous decrease in family farm incomes this year compared with 1988 and 1989. We are also concerned at the failure of the Ministers for Health and Social Welfare to instruct their officials to take this into account. There is nothing in their guidelines, instructions or signals sent out to the field staff to show that they realise what this catastrophic tumble in incomes has done to farm families. In fact, the contrary seems to be the position.
The national farm survey conducted by Teagasc shows family farm income in the disadvantaged areas, which, broadly speaking, includes the 12 western counties, to be £4,671 for 1988, the latest year for which figures are available. We do not have the figures for 1989 but the CSO figures indicate that they will be roughly the same as 1988. That figure includes all farms, the good, the bad and what I might call the bog. Naturally, farmers who draw social welfare and hold medical cards belong to the group who have poor farms. I suggest that their average income is less than £2,000 per annum and for many it may be as low as £1,000 per annum. Indeed, some farms, although farming activities are being conducted on them, do not produce any income or have a negative income. A constituent said to me last weekend, "with the type of place I have, Deputy, one needs to keep it rather than it keeping you". I know of hundreds such farms along the western seaboard.
There is a misconception in the Departments of Health and Social Welfare about farm incomes. I am not blaming the field officers who do a difficult job in a courteous and conscientious manner. What is wrong is the direction from the top and the failure to take into account the drastic drop in farm incomes. The Minister of State, who is conversant with farming, will be aware that there has been a dramatic drop this year. I am not referring to the problems created by the bad weather although there may be knock-on effects from that. I talked to a broad range of experts today about the fall in incomes this year and they suggest from preliminary figures that in 1990 family farm incomes will be down by more than 25 per cent. Those experts are predicting that the final figure will represent a drop of 30 per cent. What we are talking about in plain language is a cut of 30 per cent, in the wages of farmers. I should like to refer to the small quota milk producers in Sligo, Leitrim, Roscommon and parts of Galway. Last year those farmers received £1 per gallon for milk but the net return to the farmer from that source was 40p per gallon. This year the price of milk in that vast area is down by at least 16p per gallon which represents a loss of 40 per cent for the small quota milk producer. They are the problems dairy farmers must face. Beef prices have dropped by £100 per head compared with last year. Costs are not declining and as a result many farmers are selling their beef at a loss. Sheep prices have dropped to 36p per lb from last year's price of 46p per lb.
The Minister may tell us that there is a mechanism for dealing with special difficulties for those seeking medical cards and I am sure the Minister for Social Welfare will make a similar response about social welfare payments but that will not meet the problems faced by small farmers. There should be a general direction from those Ministers to reduce across the board calculations for farm incomes by 30 per cent. Such an adjustment is needed if those seeking medical cards and social welfare payments are to be treated fairly. The Ministers have an obligation to take urgent action to deal with the difficulties being faced by small farmers. The Ministers should show their concern for the people who are not among the most well off in our community. I suggest that the Minister of State communicate with the Minister for Agriculture and Food and suggest that headage payments be doubled.
I am pleased to have an opportunity to respond to the debate and I should like to thank the Deputies for their contribution. Coming from a small farm, representing farmers and having worked in the agri-business for 13 years prior to entering politics I am aware of their problems. In recent weeks I had discussions with farming organisations about the problems in agriculture and I concur with the sentiments expressed by my colleagues from the west. Medical cards are issued under the 1970 Health Act to persons who, in the opinion of the chief executive officer of the appropriate health board, are unable without undue hardship to provide general practitioner service for themselves and their dependants. Income guidelines are available to assist chief executive officers in reaching a decision about a person's entitlement and to ensure uniformity of decisions in the different health boards. The guidelines are increased each year to allow for changes in the cost of living.
Since the return of a Fianna Fáil Government in 1987 there has been renewed confidence in the country, in particular in our primary industry, agriculture. Consequent on this confidence was a gradual increase in farmers' incomes. Production of livestock and agri-products has reached an all time high, up to 1990. Sheep numbers are three times greater in 1990 than they were in 1980. In this, the laws of supply and demand along with the surpluses within the European Community are taken into account. There has been a somewhat inconsistent market for livestock this year to date. While some of the figures quoted by the Deputies are accurate others are not so accurate through no fault of the Deputies as they are simply reacting to the market on particular days in particular weeks. Because of this, farmers' incomes have most definitely dropped this year.
At this half-way stage it is impossible to predict the exact level of farmers' incomes in 1990. I hope the health boards, whose community welfare officers work within and for the community, are fully aware of the factual position at this stage and are taking this into account in their assessment of farmers' applicants for medical cards and their recommendations to the relevant deciding officers in each health board.
Applications for medical cards are assessed by reference to current income and the circumstances of the applicant. If a farmer's current circumstances justify the granting of eligibility then a card may be issued without having regard to whether his or her circumstances have disimproved since last year. I wish to emphasise that under 1970 Health Act the granting of a medical card is solely a matter for the chief executive officer of the relevant health board and for the delegated administrative officer who makes the ultimate decision on behalf of the chief executive officer.
The Minister for Health announced earlier this year that it is his intention to set up a statutory medical card appeal system. The necessary administrative and legislative arrangements are currently being pursued in my Department. When this system is in place any person who feels aggrieved in relation to a decision not to grant a medical card can have the problem addressed by a statutorily designated officer. Pending the introduction of that scheme there is already in place, under existing health board arrangements, a scheme to review any decision not to grant a medical card. However, I am aware of the position and as a result of this debate tonight I intend to communicate with the Western Health Board and other health boards on this matter. I expect that the factual assessments of farmers' incomes are being and will be used in arriving at decisions on medical card applications from farmers at all times.
The Dáil adjourned at 12.35 a.m. until 10.30 a.m. on Wednesday, 11 July 1990.