Health (Repayment Scheme) Bill
Mr. Gormley: It was interesting to listen to Professor Drumm this morning at the Joint Committee on Health and Children, who told us we had fewer elderly people in Ireland as compared to the United Kingdom. The reason was given to us a few months ago by Dr. Sean Barrett from Trinity College Dublin, who said Ireland had the benefit of what he called a “demographic bounce”, in that many Irish citizens who would be old at this stage had emigrated in the past to the United Kingdom. The economy benefited as a result, because the elderly cost money. In general people spend more money on health in their final years than in the whole of their previous life. That has helped this country economically, and yet what we see from this debacle is that those who have contributed enormously to Irish society were exploited. The most vulnerable people in society were basically robbed by the State. The Minister for Health and Children tried to rectify and justify this, and she was rightly shot down by the Supreme Court.
Professor Drumm spoke about accountability this morning and the better management of the health service. Like everyone else, I should like to see better management, but it was not clear to me at the end of our questioning how that was going to come about. How are we going to achieve this?
If there are certain hospitals in the State that are not up to scratch, and he seemed to be indicating there were, how are these people going to be called to account? Are managers of hospitals going to be sacked? It is not likely and so there is a real problem at the heart of the health service. What we see here today emphasises that because it was very much a case of sticking our heads in the sand on this issue. One has just to examine the lack of action on the part of a number of Ministers. The previous Minister for Health and Children, Deputy Martin, apparently did not read his e-mails or his brief and yet is quite happy to continue in office. The former Minister of State, Deputy Callely, apparently read some sections of the reports.
Mr. Durkan: He read too much.
Mr. Gormley: Deputy Callely apparently spoke to the Taoiseach about them, as he sat on the steps in the Chamber. I took the trouble of going back and looking at the video and he did sit on those steps there and spoke to the Taoiseach, where the Minister of State, Deputy Power, is sitting now. They had a discussion of some description.
Mr. Durkan: Big brother is watching.
Mr. Gormley: I do not know what was said, but apparently the Taoiseach was informed about this.
Mr. Durkan: It is amnesia.
Mr. Gormley: The then Minister, Deputy Martin, was not informed and he got away scott free. We are now left with this mess and the Bill which has to be enacted. I want to go through some of the sections of the legislation because while it seems we have a framework, we could still be heading for the courts. We are looking at patients’ private property accounts. In this context I want to mention something I have raised before. It seems the PD element of the Administration is pushing this, but there are problems on the horizon as regards the Government’s approach. It is quite clear that while incomes in Dublin are 15% higher, homes there are also 15% higher. In other words, means testing care provision on the basis of a State-wide fixed figure would be triply unfair. Many of my constituents will be burdened with this in the future. Dublin families have paid a disproportionate amount of stamp duty revenue, suffered greater indebtedness and are now, in effect, being taxed on the basis of the paper value of a home that is entirely eroded because any replacement for it must ordinarily be found in the same market. That will come back to haunt certain people in the PD ranks of Government, who may know patients living in high-valuation properties, who will forfeit these assets, and their children will suffer as well.
As regards the appointment of an outside company I begin to wonder where is the Civil Service. We have a Civil Service to do a job and all we are getting is a continual outsourcing of business. We see from the public private partnerships in action throughout the State that they do not necessarily work, either for the benefit of the citizens or the State. At a recent meeting at Dublin City Council, the City Manager, Mr. John Fitzgerald, who has performed very well, was quite candid in stating he did not believe the private sector could perform any better than the Civil Service. Why do we continue to give out work to private bodies? It costs the taxpayer a great deal more in the long-run. Taking just this element, already we are in difficulty. The Minister of State made it clear in his contribution that tenders were sought an initial procurement process was undertaken by the HSE in the latter half of 2005. There were 11 expressions of interest for the design and administration of the repayment scheme, and three were short-listed.