Sandra McLellan (Cork East, Sinn Fein) | Oireachtas source

I welcome the witnesses and thank them for their presentation. Regarding the current control framework and the sharing of data between the HSE, the Revenue Commissioners and the Department of Social Protection, what type of legislation is pending and can the witnesses assure people that they will protected under the Data Protection Act? I am happy to hear that the National Adult Literacy Agency is involved in the revision of application forms and letters and I ask the witnesses to elaborate on how successful the effort to make application forms more user-friendly has been.

According to the presentation, there has been a 74% increase since 2005 in the number of people who are eligible for a range of health services covered by the GP visit cards. How does the HSE plan to address the issue of growing demand at a time of limited funding? The witnesses also mentioned that there will be a reduction of 40,000 in the numbers holding full medical cards. What eligibility criteria will be used? Is the HSE planning to lower the income threshold for qualification, bearing in mind that many people have far less money in their pockets now?

The standard medical cards are relatively easy to get but it is still very difficult to obtain emergency medical cards. There are also enormous problems pertaining to the discretionary medical cards where, for example, people who would have been approved for medical cards on discretionary grounds are quite often only given a GP visit card once their discretionary card comes up for review. They then have to go through the process of applying for a discretionary card all over again. Such people are presenting to our constituency offices and explaining that they are not taking their prescribed medication because they have been issued with GP visit cards and cannot afford to fill their prescriptions. Another concern in this regard is the difficulty for cancer patients in obtaining discretionary medical cards. I have found, through my constituency office, that many such patients are being refused discretionary medical cards. The HSE might argue that their income is above the medical card threshold but that does not take into account the true cost for people of dealing with cancer. People with young children, for example, need to pay for additional child care and in some instances, also need help with cooking and general housework because they are so ill and are in bed for weeks on end. It costs money to buy take-away food on occasion, to travel to and from hospital, to park one's car at hospitals and so forth. Such expenses over a 12-month period can add up and I do not think such issues are being taken into consideration.

On the issue of orthopaedics, I have been told by several people that they have been waiting for up to four years for treatment. People are put on a waiting list for the waiting list, so to speak. When the HSE representatives talk about reducing waiting lists, are they talking about one list or all of the other lists along the way?