Seán Crowe (Dublin South West, Sinn Fein) | Oireachtas source

I would like to return to the medical card issue. As a committee, we said we would put it on the work programme at some stage and do a session on it. One of the reasons I suggested we should try to focus on it today is the number of cases we get as Deputies but also because of what Deputy Gino Kenny said about that document that went back ten years or whatever it is. There is clearly a need to review the whole system as we move forward. The big challenge we have as elected representatives is around those people who are in that grey area because they are a handful of euros over the threshold or whatever.

The other big challenge we keep returning to is that people who are seriously ill are being asked to come up with information relating to their application. Whatever about the salary or income eligibility, which is possibly accessible, if someone is seriously ill, it is very difficult to get a letter from a doctor. They would have to go to the doctor. They might have to get a letter from a consultant or whatever else. That is the big challenge that a lot of people say they are facing. It is not easy to get a letter off a doctor or a consultant. It is equally challenging for someone who is on oxygen for 24 hours and is asked to supply all this information. I have given this example loads of times. Recently the same person who had an emergency card was asked to supply their full medical file, which seems extraordinary. It is very difficult for people in that situation. Is there any way of looking at the system that takes cognisance of the challenges people are facing trying to get that information, or is that set in stone? If someone is attending two or three hospitals and is under two or three consultants, is that not sufficient? Do they have to get a letter from all those consultants? You would imagine they could use a letter from a GP but in this situation they are having difficulty getting the letter. Is there any way the system could be more flexible, particularly for people who are seriously ill?

Going through the list of those who automatically qualify, if someone has motor neurone disease, you would imagine they would. I could go through a whole list of illnesses. Over the years people have talked about qualifying if something is a lifelong illness, say if someone is a coeliac or if they have Crohn's disease, Parkinson's, etc. There is a list of illnesses but they are not included in the system. Is there any way of looking at that? The other big challenge relates to those who are declared as terminally ill. Mr. Gloster himself mentioned the difficulty of getting a consultant or someone from the medical profession to say a person is only going to live two years. Can that be tweaked or looked at? We all collectively believe that is the right approach that should be taken to people in that situation. How can we do that?

I know I am putting the witnesses on the spot. Maybe it is a Government thing that needs to be done. It is something we as a committee need to return to, particularly around the salary issue. Deputy Kenny gave the example of someone whose income might be quite good on the surface but if mortgage, rent and all those other things are taken into account, there is not much left. They might have a child in university or whatever else. Those are the collective things that do not come into play for eligibility for the medical card. I ask the witnesses to comment on that.