Dáil Éireann díospóireacht -
Thursday, 15 May 2014

Vol. 841 No. 3

Leaders' Questions

Deputy Billy Kelleher

Over the past 18 months, when the issue of discretionary medical cards was raised and the removal of discretionary medical cards from very sick people was being highlighted in this House and throughout the country, there was a denial in Government that there was any change in policy. Whether there has been a change in policy or in practice, there has been a change because people are having their discretionary medical cards removed on a continual basis. The figures and statistics are there and more than 30,000 discretionary medical cards have been removed over the past number of years.

The Joint Committee on Health and Children is in the medical card centre in Finglas today observing how discretionary medical cards and other medical cards are assessed.

Deputy Finian McGrath

Another stunt.

Deputy Billy Kelleher

I have no doubt the staff there work exceptionally hard and diligently but the difficulty is that they are doing the Government's bidding in regard to the removal of discretionary medical cards. A Private Members' motion this week and one last year highlighted, and advocacy groups continually highlight, the fact discretionary medical cards are being removed and yet the Government denies there has been any change in policy. Even as late as last year, it was in the HSE service plan that there would be a removal of discretionary medical cards.

The reason I raise it today is that we have raised it with the Taoiseach and on Private Members' business and the Tánaiste is our last chance to get this Government to accept there has been a change and to reverse that change. Children with Down's syndrome have been asked whether their condition has improved, as have people with motor neurone disease. Let us be very clear - Down's syndrome is with one for life and motor neurone disease takes one's life and yet people are being asked these questions on a continual basis. In the House yesterday, in response to a question by Deputy Martin, the Taoiseach stated, "there is not an attempt here to show lack of understanding, compassion or consideration for people who have these challenges" and that it was a question of being fair. What is unfair is asking the oldest and the sickest to pay free GP care for those under the age of six which will, in many cases, be given to healthy and wealthy people.

The Tánaiste

I accept there is a problem with the way in which the review of discretionary medical cards is being carried out. The number of medical cards which is in circulation now is significantly higher than it was a number of years ago. There has been a 46% increase in the total number of medical cards. Almost 600,000 additional medical cards are available now than in 2008, for example. As I understand it, and I have spoken to the Minister about this, 96% of those reviewed to date have retained their medical card.

There are a number of problems, as I see it. The first problem is that when a letter comes in the door stating that the medical card will be reviewed, it causes worry and upset and a better way has to be found of conducting the actual review. The second problem arising is that people who are reviewed once are very often reviewed again a number of times. In particular for older people, it constitutes a degree of harassment where somebody receives letters again and again within a very short period of time essentially asking the same questions. There is no justification whatever for somebody getting a letter asking if his or her child still has Down's syndrome or somebody getting a letter asking if he or she still has motor neurone disease. That type of approach must be dealt with.

In terms of solutions, a number of things can be done. Where a review takes place, there should be a freeze on that person being reviewed again for a period of time. Where it is proposed to withdraw a medical card, a reasonable period of time should be given to that person to enable them to appeal the decision and to make a case, if there are exceptional circumstances in the household or exceptional medical circumstances, for example. Perhaps a small additional inquiry should be made. I know of a case, for example, where a medical card was withdrawn where the person had moved to a nursing home. Clearly, that could be established by a small additional inquiry.

Where the medical card is being withdrawn and where issues arise in regard to access to services, which is an issue for people, the Minister has committed himself to ensuring that access to services is made available. Again, a period of time should be allowed for that.

I am very glad the Joint Committee on Health and Children is in Finglas today talking with the staff dealing with the review of the medical cards. I hope that arising from that visit, it will be possible to progress a number of practical recommendations which can address the kind of problems we all see arise from the review.

Deputy Billy Kelleher

The programme for Government guarantees access to medical care based on need and not on income. That is a central tenet of Government policy in regard to health delivery. Fairness should be at the heart of any policy. The Irish people are very fair when it comes to deciding whether free GP care for all those under six should be funded by taking discretionary medical cards from the oldest and the sickest society, which is stated in the HSE service plan and is stated Government policy, namely, that it will reduce the number of discretionary medical cards while announcing that €35 million will be ring-fenced for GP care for those under six. By ring-fencing that money for GP services, the Government is taking it from those who are the sickest and the oldest in our society who need it most.

Even at this late stage, would the Government not revisit that policy where it is taking cards from children with Down's syndrome, who are over six, elderly people who have life-limiting illnesses and conditions, people with motor neurone disease and people who have had double mastectomies? What is happening is criminal and yet the Government is saying that the under six policy is one for delivering health care. It is not, it is the opposite.

An Ceann Comhairle

A question, please.

Deputy Billy Kelleher

Clearly, what the Government is doing is ensuring that those who need the supports of the State most do not get it and that those who can afford them will be able to access their GPs for free. Would the Tánaiste not agree that if the Government is genuinely interested in social solidarity that it should revisit this and ensure there is funding in place for those who need it most? We can address the issue of universality when conditions improve but in the meantime, we should not ask the old and the sick to pay for this particular policy.

The Tánaiste

I know that Fianna Fáil is opposed to the Government plans to extend free GP care to children under six.

Deputy Billy Kelleher

The populist thing would be to welcome it and to ask for more.

The Tánaiste

However, that does not justify distorting the facts. The facts are that the provision of free GP care for those under the age of six was additional funding which was provided for in the budget last year.

Deputy Billy Kelleher

The Tánaiste should read the HSE service plan.

The Tánaiste

As the Deputy well knows, that policy is the start of the phased introduction of universal free GP care as part of our policy to transition the health service to one where there is universal health cover.

In regard to the general issue of medical cards, as I said earlier, there are now more medical cards in circulation than at any time.

Second, everybody in this House, and anyone reasonable, would accept that from time to time it is necessary to review who has a medical card. I do not think anyone would justify a situation where, for example, payment is made for medical cards that are either no longer in use or where a person has passed on. I acknowledge that the way in which the review of medical cards has been conducted has caused and is causing a lot of distress, in particular to elderly people. I have talked with the Minister about it and the approach I outlined about additional care being taken in terms of the way in which reviews are conducted, and additional time being made available to people where there is a proposal to withdraw a medical card, is the route to go.

Deputy Mary Lou McDonald

Today, we will commence statements on the report by Mr. Guerin. However, I wish to step back a couple of weeks to revisit the account of events given by An Taoiseach in respect of his knowledge of the revelations of the practice of taping phone calls to and from Garda stations. Those matters are the subject of a separate commission of investigation led by Mr. Justice Fennelly.

An Taoiseach has stated on the public record that he was first informed of the taping practice on Sunday evening, 23 March, when during a phone conversation with the Attorney General on an unrelated matter, she raised the issue. The Taoiseach then said that on Monday 24 March he met the Minister for Justice and Equality and Brian Purcell, Secretary General at the Department of Justice and Equality, and that he asked Mr. Purcell to go to see the Garda Commissioner at his home. We all know that this meeting resulted directly in the subsequent resignation of the Garda Commissioner.

It strikes me that the Tánaiste was left out of the loop in that sequence of events, and that was confirmed again by the subsequent developments around the resignation of the former Minister for Justice and Equality, Deputy Shatter. I will say no more about that.

I have obtained, through a freedom of information request, the Taoiseach’s diary from the week in question. It does indeed refer to a meeting or conversation with the Attorney General on Sunday evening, 23 March, at 5.30 p.m. to be precise. However, it also contains a reference to an earlier meeting on that Sunday and it reflects that at 7.30 a.m. the Taoiseach met the Minister for Justice and Equality and his officials. The Taoiseach has made no reference whatsoever to that meeting in his public account of the events or in his account to the Dáil.

An Ceann Comhairle

Could the Deputy ask a question please?

Deputy Mary Lou McDonald

A number of questions arise. Was the Tánaiste aware of the meeting? Did the Taoiseach inform him of it? Could he tell us which officials from the Department of Justice and Equality were present at the meeting? Was Brian Purcell there? Could he tell us what was discussed at the meeting? Was the taping of phone calls to and from Garda stations discussed? Was the fate of the Garda Commissioner discussed? Might that explain the marked reluctance of Brian Purcell to deal with the matter before the Oireachtas Joint Committee on Justice, Defence and Equality?

The Tánaiste

It seems to me that they are all questions Deputy McDonald should usefully put to the Taoiseach. I do not keep the Taoiseach’s diary. I do not know what meetings he did or did not have on Sunday 23 March. With the greatest respect, Deputy McDonald should ask him directly about those issues.

What I do know is that the Government took the question of the taping of conversations in Garda stations very seriously. I had an opportunity to address questions on the issue previously. I made the point that it is very serious from the point of view of people whose conversations were taped and of gardaí whose conversations might have been taped without their knowledge. From what we were told at the time, there were a number of taped conversations. What we have done in respect of that is to establish a formal commission of investigation which is chaired by Mr. Justice Nial Fennelly. It was established very quickly by the Government on 1 April, very shortly after the information came to light. The commission has been asked to report back by the end of the year. A Supplementary Estimate to ensure the commission is able to do its work was passed by this House, and I have no doubt the commission will in any event examine some of the various issues raised by Deputy McDonald this morning.

Deputy Mary Lou McDonald

It is very clear that not alone does the Tánaiste not keep the Taoiseach’s diary, he is clearly not informed or perhaps kept abreast of some of the significant meetings that take place within the diary. I am sure he will agree with me that it is very important for the purpose of public confidence, but also for the purpose of the confidence of Members of the Dáil, that we are sure a full account of events as they transpired is given in the House. People watching as the sequence of events unfolded remarked at the fact that there were information gaps. The view was that things that were wildly implausible were placed on the record of the House and insisted upon as a full account of events.

I have the diary and it says that at 7.30 a.m. on the Sunday the Taoiseach met the Minister for Justice and Equality, who was just back from Mexico, and his officials. I assume that Brian Purcell, being the most senior official, was present at the meeting. The Tánaiste clearly had no notice and no knowledge of the meeting. That is an issue of concern for him. Given the seriousness of those matters, I would have thought he would have forensically trawled through the sequence of events, and who met who and when, with the Taoiseach. That is what I would have done if I were in his position.

Will the Tánaiste establish for us the following facts? Why was the meeting scheduled so early on a Sunday morning? It is not part of the Taoiseach’s routine to meet officials at 7.30 a.m. on a Sunday. We know that because we have his diary. Did the meeting take place? It is in the Taoiseach’s diary so we presume it did. Who was at the meeting? What was discussed at the meeting? Was the taping of phone calls discussed? Were issues relating to Commissioner Callinan discussed? Crucially, why is it that in all the Taoiseach has had to say on these matters to “put Paddy in the picture”, as he would put it, this particular meeting has been edited out of his script? Does the Tánaiste agree it is a matter of concern for Members of the Dáil and for the Tánaiste if a meeting at that level was held at the time and he knew nothing about it and neither did we and the Dáil was not informed of it?

The Tánaiste

The taping of conversations in Garda stations, which is what this is about, is now the subject-----

Deputy Mary Lou McDonald

No, this is about-----

An Ceann Comhairle

Please.

The Tánaiste

I will get to the meeting in due course. The taping of conversations in Garda stations is the subject of a commission of investigation. It behoves us all to let the commission of investigation, which is being chaired by a Supreme Court judge, to get on with its work.

Deputy McDonald asked me to account for what is in the Taoiseach’s diary and meetings he had. I am no more in a position to do that than she is to account for what is in her party leader’s diary. I cannot tell her – I do not know if she knows what meetings her party leader might have had, who he might have met, what time and whether she has access to his diary. If she has questions-----

Deputy Mary Lou McDonald

That is a non-answer.

An Ceann Comhairle

Please.

The Tánaiste

If Deputy McDonald has questions, she like everyone else is perfectly entitled to make a freedom of information request and to get the diary of the Taoiseach, my diary or that of any other Minister. That is what is available under freedom of information.

With the greatest of respect, if the Deputy then has detailed questions about meetings the Taoiseach, I or any other Minister had, the person to whom the questions should be put is the person whose diary the Deputy has-----

Deputy Mary Lou McDonald

Did the Tánaiste not put this question to him?

An Ceann Comhairle

We are over time.

The Tánaiste

The Deputy is using a very clever politically-motivated approach to the questioning. If the Deputy has questions to ask the Taoiseach about his diary she should come in here and ask him questions about the diary and he will answer them.

Deputy Mary Lou McDonald

Does the Tánaiste have questions to ask him?

Deputy Pádraig Mac Lochlainn

Does the Tánaiste have any concerns about it?

Deputy Clare Daly

We were all a little bit disappointed last week that the Tánaiste was not here to answer questions on the dramatic departure of the former Minister for Justice and Equality only hours after his ringing endorsement of him. Having listened to his response to Deputy McDonald the idea that he is almost taking pride in his total lack of involvement or supposed knowledge of one of the biggest crises in the history of An Garda Síochána is, to me, absolutely astounding, but we will deal with this later when discussing the Guerin report.

I wish to raise an issue which affects every citizen in the State, and one on which the Tánaiste made his political name through his opposition to water charges. The Tánaiste is no doubt aware that last week Irish Water issued an instruction to all of its contractors to withdraw from the installation of water meters in working class estates and to retreat to the more affluent suburbs where they were less likely to meet resistance, a resistance which was growing and active in Cork and Dublin, no doubt in a vain hope the electorate would forget about this issue. When the canvassers are gone, the posters are taken down and the recycling bins have been emptied of all of the leaflets homeowners will be faced with another bill when they cannot even meet the ones they have in the first place. Not just this, but they face the obscenity of footpaths continuing to be dug up to install water meters against the backdrop of a 40% reduction and leakage of expensive treated water, when the same crews, with extra people, could dig up the same streets to repair the network. This is nothing short of high order environmental vandalism.

When the Tánaiste's colleague, the Minister, Deputy Howlin, was Minister with responsibility for the environment in the 1990s he brought out a KPMG report on the financing of local government in Ireland. It is a good read and I have it here. It made the point that domestic water metering was an uneconomic proposition and that water should be funded from central taxation, and so it was decided that local authorities could keep the funds from the motor tax, a source of revenue which has increased four times. We kept paying it but the Government decided to pilfer the account to pay the national debt. To add insult to injury this is being dressed up as a conservation measure. Is it not the case that water charges have nothing to do with the funding of water services but are in fact another toll on public services to pay for the national debt?

The Tánaiste

To answer the first part of the question, I am proud of the decisions the Government has taken to introduce major reforms in the governance of the Garda for the first time since the 1920s. The establishment of an independent Garda authority which will be drawn from a broad swathe of Irish society, the extension of the whistleblowers legislation to include gardaí and the ability of gardaí to go directly to GSOC if they have complaints are major reforms in the way in which gardaí are managed. When all of this episode is over these reforms will certainly stand the test of time.

With regard to the second part of the Deputy's question, charging for water is precisely to fund water services and ensure funding is available to deal with the problem of leakages, as we have approximately 40% leakage from the system, the difficulties of boil water notices and the danger that major urban areas including Dublin will find themselves without an adequate supply of water because of the lack of investment in the water system over many years.

In introducing the charges we were very mindful to introduce them in a way that is fair and reasonable. There will be no fixed charge. There will be no standing charge. There will be a free household water allowance and an additional allowance of 38,000 litres for each child. There will also be a household package available to pensioners, carers, those with disabilities and those who qualify for the household benefit package, which will be €100 a year. There will be a cap on the payment for people who have medical conditions and require the use of additional water. Charging for water will be on a metered basis, so it will be on a usage basis, which has the double advantage of encouraging conservation of water in the first instance and enabling households to reduce their water bill.

Those households which are not metered by the time the charging system comes into effect will have the opportunity of getting a rebate of the charges paid if they are over the amount they have used once the metering system has come into effect. The charges concerned will be used to provide the funding that Irish water needs to ensure the people of this country have an adequate and safe supply of water for the years ahead. In addition to this the Government is providing a subsidy to Irish Water of €537 million.

An Ceann Comhairle

I remind all concerned that only one topic is allowed on Leaders' Questions.

Deputy Clare Daly

I want to refer to the Tánaiste's point in which he addressed the-----

An Ceann Comhairle

No, we will not refer to two topics. The Deputy caught me offside. I will not be caught a second time. It is like a good footballer who gets caught offside.

Deputy Clare Daly

We will take it up in the discussion on the Guerin report because the Tánaiste has some neck to talk about reform when he staunchly opposed it last year.

An Ceann Comhairle

No, we will not deal with this now. The Deputy cannot have two bites of the cherry. She raised the issue of water and must stick to it.

Deputy Clare Daly

It is one rule for one and the other-----

An Ceann Comhairle

No it is not. The same rule applies to everybody in the House.

Deputy Clare Daly

Previously the funding of local government required that motor taxation revenue would go to fund local authorities. The Government pilfered this account and took money, which we as car owners have continued to pay, from the local authority budgets to pay the national debt. Now it is looking for it again. To listen to the Tánaiste one would think the local authorities never fixed a water main or brought in any programmes to remediate. Is it not the case that under the Government not a single kilometre of water mains has been repaired? Is it not the case that within a kilometre of this building are massive public buildings where not one measure such as rainwater harvesting or other conservation measures has been imposed? The local authorities in the greater Dublin area were working on a geographic information system project involving mapping, leakage and telemetry of our water system. This project cost the taxpayers millions and has involved tens of thousands of staff hours. It was almost at completion, which would have been brilliant to secure our understanding of our water supply, but Irish Water has axed it. It will not go ahead because somebody in Irish Water's friend, who works in Bord Gáis, has a different computer system. What is unfolding in Irish Water will make the HSE look like an efficient fit for purpose organisation. It is nothing more than a quango lining up our water services to be privatised to Denis O'Brien, who has done the Government some nice favours through his ownership of Independent News and Media.

An Ceann Comhairle

The Deputy should not make comments like this. This is a serious issue. Do not bring in other people.

The Tánaiste

Whoever Independent News and Media have done favours for it is certainly not me or my party.

Deputy Finian McGrath

There are a few nice photographs in it today.

The Tánaiste

I would go again on this one if I were the Deputy.

Deputy Billy Kelleher

The Tánaiste is suffering like us.

The Tánaiste

Perhaps I did not hear the Deputy correctly, but with regard to being opposed to a Garda authority-----

An Ceann Comhairle

Please do not go there.

The Tánaiste

I just wanted to have an opportunity-----

An Ceann Comhairle

Stick to water.

The Tánaiste

I will take the Ceann Comhairle's admonition and will stick to water.

Deputy Billy Kelleher

That is equally uncomfortable for the Tánaiste.

The Tánaiste

First, the local authorities have done a good job in their management of the water resource. The engineers and staff of the local authorities who have worked on water down through the years certainly have done a creditable job. However, there were 34 different water authorities nationwide and just as one would not, these days, have 34 different local distributors of electricity or gas, as was the case in the past when there were local generators and distributors of electricity, it does not make sense in the modern world to have such a multiplicity of deliverers of any utility, including, in this case, water.

There are a number of issues pertaining to water that must be addressed, the first of which is the adequacy of the supply. We have been fortunate and it has been a credit to the local authorities in Dublin that we have not ended up with a water crisis in Dublin. Over the greater Dublin area, not just the city itself but the greater Dublin catchment area, as the development of the city continued and as it grew, there was insufficient investment in the delivery of water to supply the people adequately. Consequently, we have been fortunate to avoid a crisis in that regard. Irish Water will be investing in the delivery to ensure there is an adequate supply of water. We have not been so fortunate in other cities. In Galway, for example, people ended up with a serious problem some years ago. Similar problems exist in other parts of the country, where the quality of water is substandard and this requires investment. This is why there must be a fund to underpin the spending that must take place to ensure the continuation of an adequate supply of clean water. The system of charging for water that the Government has brought in, which is based on usage, which takes account of family size and medical conditions as well as people who have problems with ability to pay, is a reasonable arrangement. Instead of some of the scare stories that are being told to people in this regard, Members need to provide people with the facts.