asked the Minister for Health the proposed new income level for those considered eligible for free hospital services.

22.

asked the Minister for Health when it is proposed to introduce the £7,000 limit for free hospitalisation agreed under the current national understanding.

23.

asked the Minister for Health the arrangements made to date to implement the revision of the health eligibility limit from £5,500 to £7,000 in accordance with the National Understanding for Economic and Social Development.

With the permission of the Ceann Comhairle, I propose to take Questions Nos. 21 to 23, inclusive, together.

The present health eligibility limit of £5,500 will continue until April 1980. In the meantime in accordance with the terms of the national understanding the Government are introducing an interim scheme to compensate persons in the income range £5,500 to £7,000 for certain medical expenses incurred by them in relation to the period 25 July 1979, which is the date of implementation of the national understanding, to 5 April 1980, the date to which the limit of £5,500 operates.

The expenses involved, and for which a payment may be claimed, are:

1. Portion of the premium paid to the Voluntary Health Insurance Board for the board's public ward scheme.

2. Hospital consultants' bills to persons without voluntary health insurance for services received as in-patients in public wards.

3. Hospital consultants' bills for services received as out-patients in public clinics.

4. General practitioner bills for maternity services.

Full particulars of the interim scheme will be announced shortly.

The Minister was not party to the national understanding negotiations, but would he agree that to negotiate an understanding which included a proviso that £7,000 would be the limit without having concluded the necessary negotiations with the profession involved was securing an agreement under what were effectively false pretences?

I would not agree.

Is it not a fact that the Medical Association can still refuse to accept the proposal and the undertaking given and that the understanding, therefore, falls to the ground?

I would not agree, but questions in connection with the national understanding should be addressed to the Minister concerned in the negotiation of that. In so far as the arrangements I am talking about here are concerned, the Government are meeting their obligation fully and honourably.

May I ask the Tánaiste——

I thank you.

Or the Taoiseach.

Is the Minister aware that between 6 July last and now and certainly between 6 July last and 5 April 1980 many thousands of persons on income rates of between £5,500 and £7,000 will receive accounts, and indeed have now actually received accounts, from consultants and so on and no regulations have yet been published, no indications have been given as to when and what the arrangements will be for the repayment of those? Should persons hold these accounts, not pay them, and then when the arrangements are made send the accounts to the Department of Health, or what should they do?

In general terms, nobody in that category need have any worries. In so far as people have paid since 5 July or will pay until next April any consultants' fees these will be repaid to them. There would be a lot to be said for them submitting the bill that they get and getting paid on that and then paying the consultant. That has to be worked out.

Finally, to whom will they submit this bill ultimately? Is it to the Department or to the health board?

The VHI will be our agent in this matter.

Has the Minister had agreement with the unions on this variation of the national understanding in relation to the health eligibility limit? Secondly, has he considered the anomaly whereby a single person and a married man with maybe six, seven or eight children have the same eligibility and that some consideration should be given to the man with a family? Will he consider providing an extra allowance for spouse, per child and so forth?

Is the Deputy talking in the long-term apart from the immediate situation with which we are dealing?

Yes.

The Deputy will recall that we had that discussion when we were putting the legislation to the House and I was not able to find any readymade solution to it. So far I have not done so. It is slightly anomalous. It is very difficult to make arrangements to cater for every separate occasion.

Can we take it that, no matter what happens between the Minister and the Medical Association, this figure of £7,000 stands? Does this undertaking given stand in relation to the level of eligibility?

The undertaking of the Government to the category of persons between £5,500 and £7,000 in the last financial year stands as long as the national understanding remains.

Question No. 24.

In other words, anybody whose income for the year ended April 1979——

Was up to £7,000?

Yes, between £5,500 and £7,000. Any expenses they incurred for consultants' fees would be reimbursed.

Has the Minister had consultations with the ICTU on this subject and has he got agreement?

My colleague is in constant communication with congress.

Did he get agreement on this variation of the national understanding?

As far as I know, the arrangements have been welcomed by the congress.

Is the Minister aware about reports that the biggest unions in the country are very upset at the variation——

This is widening the scope. We are getting into debate now. The Deputy will have an opportunity to raise that. I am calling Question No. 24.