John McGuinness (Carlow-Kilkenny, Fianna Fail) | Oireachtas source

Perhaps we should also send the transcript of this part of the meeting to the CRC, with the appropriate information that has been submitted, and request a full response to the queries raised. I will ask the clerk to do so.

Regarding the other section 38 organisations that have not responded or to which the HSE is writing, it should be made clear by this committee that we have serious concerns about the situation. We are also concerned that they have not responded within a reasonable time to the queries that the HSE has put to them. This is simply not acceptable to the organisation immediately responsible for what is happening, or to us as the committee that must examine the situation. It would be in their best interests to respond comprehensively to the queries the HSE has raised with them and to the queries that they have undoubtedly heard from members today so that we can clarify matters and, as members have stated, try to restore some confidence among those who support them in a voluntary and financial fashion. I would like to see a lot more co-operation. We will meet the Department of Health and the Department of Public Expenditure and Reform to discuss how the matter has been managed over the years, because it is simply unsatisfactory. It took Deputy Ross, for example, to give us the information on the payment made to the CEO that amounted to €266,000 when one includes the top-up money and the pension contribution. That is unacceptable. It also important for us to point out here that the control environment was seriously inadequate. I know Mr. O'Brien and his staff are working on the matter and afterwards we will see some sort of conclusion.

I do not wish to pick any bones with Mr. O'Brien, but he stated in his opening remarks what was said in the public domain about the report and how it was presented to the committee last week. The report was presented on 15 March of this year, within his own organisation, to various individuals. The reason I was concerned about how it was presented to the committee was that the meeting took place on 14 November, so the HSE pondered the report from March until November. It might have been better if the report had been given to us earlier and properly. That is my only concern about the matter.

The HSE's report is very good. Like what Deputy Ross has said, the HSE should not be afraid of naming names and releasing the figures attached to the names. Apart from political or media analysis, we would have a fact-based document that contains literally everything from A to Z. We must strive towards that type of report, which will help everybody. I thank Mr. O'Brien and his officials for attending here at short notice.

I wish to refer to two matters very quickly. I know that the HSE will be very busy between now and Christmas and I may not get another chance to say the following to Mr. O'Brien. I want to put on record the fact that I raised the issue of reviews and appeals at the last meeting when we discussed medical cards. I will not reopen the debate, but I want to mention two things. The person who dealt with reviews and appeals of medical cards looked at me in disbelief and said he did not see how that kind of letter would have gone out. There were 29 different pieces of correspondence around these medical cards that the HSE deals with. I want to read into the record of this committee that an applicant was told in a letter that their application could only be reviewed if they had additional relevant information. This was a case in which all of the information had been given. Everything had been put before the HSE's medical card section and a review was requested due to the serious nature of the illness of the applicant - who, by the way, has since passed away. I raise the matter because it caused a difficulty for that particular applicant and their family, because they could not get someone within the HSE to understand that a review was absolutely necessary and urgent. In case the delegation thinks this was an isolated case, I checked my old files as quickly as I could today and found a second instance in which a review was denied unless relevant information was given. The applicant had given information from her consultant and doctors, as well as all kinds of personal information. After dealing with all of the issues raised in the correspondence about medication, money issues and so on, the applicant wrote:

So, you are asking for new information. Well, here it is. We cannot afford our healthcare and medication without a medical card. We have cut back on the tablets that our GP says we must take to stay alive. Our lives may be shortened or abruptly end because of your decision.

All that person wanted was a review because she believed their cases were urgent because they were not taking their medication.

I have had to quote these to prove that letters are being issued that give the impression, though possibly not intentionally, that a review can only be considered if there is fresh evidence. I further stated at the meeting that consultants and doctors were getting annoyed with these patients returning to them asking for fresh proof that was necessary, as if it were needed in either of those cases, to restate their position. I do not want to reopen the debate on the matter. I just wanted to clarify that I have the evidence. I thank Mr. O'Brien's officials for the direct assistance that they have given when we raised such concerns.