Bernard Durkan (Kildare North, Fine Gael) | Oireachtas source

I have been out to the headquarters on several occasions. I am not a great supporter of the centralised system at all, and I hope that in the not-to-distant future we can see decentralisation, in the four regions perhaps, and with that simplification. I have brought this up before. The HSE told us a week ago there is no automatic right for a cancer patient to have a medical card. I find it hard to explain to the patient or constituent in a situation where everyone is stressed and wondering how quickly they can get their medical card, if at all.

Some of the questions are insensitive. If one receives a letter from a doctor to the effect that a patient is terminally ill a card will issue. That is not a great help to the patient, I have to say. It does not reassure the patient in any sense. There is a certain inevitability about it that I regard as a bit insensitive.

I know that spot-checks have to be made. It is commonly said to patients that there is an awareness of their changed circumstances even though their circumstances have not changed at all. It takes an inordinate amount of time to process some of those cards, especially if there is a question asked. I am not blaming the staff, but that system does not work.