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

The problem I am concerned with is the emphasis on a number of occasions on the reference to end of life. My response to that is that people who have a life-threatening diagnosis have enough to be worried about without trying to determine whether they can get a letter from somebody to say they have two or three months to live, or whatever the case may be. They are suffering enough already. I presume the services would be sufficiently sympathetic to their position to take on board what has been said to them in good faith, knowing there will be some other time for review in any event. I would like much more emphasis placed on that part, in other words, on sympathy with the patient who has a serious problem on his or her hands.

Another issue that has come up on a few occasions recently concerns an application for a medical card from a person whose income is over the limit but who has a serious diagnosis. A letter from the GP is not sufficient. It has to be a letter from the consultant. Due to the general data protection regulation, GDPR, the consultant will not send the letter to the advocate. Incidentally, all public representatives are advocates and we should not forget that. Our job is advocating on behalf of our communities, and we are not always wrong. The point at issue is that after much toing and froing, with a lot of stress on the patient, the spouse had to go to the consultant to get the letter. Otherwise, it was going to go into the mix and might not come out of the system for five or six weeks. Five or six weeks is a long time to somebody who is in pain and concerned about their health and their financial position. I would like to see more sympathetic processing of medical cards in those particular instances.

Regarding the points raised by a number of speakers, generally speaking, the health services are supposed to respond to the needs of the people as and when the needs arise. Ninety per cent of the time members of the public do not have to rely on the health services but when they do, they anticipate a sympathetic response. I repeat the words "sympathetic response" again and again. If they do not get that they feel ignored. To be ignored at any time is a serious issue. To be ignored at a time of health-related stress and pain is a very serious issue.

Deputy Cullinane raised a question about orthodontic treatment. The position has not changed one bit in the past 20 years. The system has avoided the issue when it should have been simple to refer children for treatment at an early age. Instead of creating two or three categories, in one of which they will never receive treatment, and pushing as many people as possible into that particular category, we should be doing it in a different way. We should deal with the cases on the basis of their necessity and severity and not presume that they will be all right in any event.

The new reimbursement system and the authorisation of new and orphan drugs has been an issue for a long time, continues to be an issue and will remain an issue. I appreciate the fact that drug companies should not be allowed to charge what they wish. That has to be dealt with at a different level but we need to be mindful of the need to respond to the particular drugs that are required by the patients and prescribed by a medical doctor.