Ms Averil Power:

I thank Deputy Ó Cuív for raising the broader issue of medical card eligibility. It is certainly something on which we have advocated on behalf of all cancer patients. When someone is diagnosed with cancer the patient and often a loved one must stop work or reduce their hours. The research in our report on the real cost of cancer found this can result in an average drop in household income of €1,500 a month or up to €18,000 a year. This is the drop in income for people as a result of a cancer diagnosis. At the same time, they are hit with extra charges for things such as medications, car parking charges at hospitals, travel to appointments and energy costs. All of this that adds up very quickly. While we are here specifically to speak about those in palliative care and cancer patients, end-of-life financial hardship is a massive issue for cancer patients in general. This is certainly something on which we are advocating.

Specifically with regard to what we are putting forward today on behalf of those who have a life-limiting cancer diagnosis, there is no doubt but there is a lot of truth in what Deputy Ó Cuív said about how difficult it is for people to accept the diagnosis. One of the greatest challenges with night nursing is often that we get called in too late. We can provide up to ten nights of care and we will go beyond this when someone needs it but our average is only three and a half nights of care because people often only bring us in at the very end. This is because it can be difficult for people to know they are that close and to accept it. There is no doubt that it is certainly an issue.

With regard to the financial side and the two years, this is what we have worked for and achieved with medical cards. We do find that it works. Because of the sheer tsunami of costs and the massive drop in income, people feel they do not have a choice, whether they like it or not, about getting the letter to qualify for the medical card. We think it would be the same here. Most people would still do their very best to beat the odds. They would state they have to get the letter from the doctor stating they have less than two years to live but they would do their damnedest to beat those odds and make sure the prediction is not a reality.

I welcome Deputy Ó Cuív's insight and expertise not only as a long-serving Deputy working with constituents on these issues but also as a former Minister for Social Protection. The question is how we work around existing schemes. We do advocate for everything to be opened up as much as possible but on this particular issue we are asking how we can have something that is limited and precise, uses existing schemes and definitions, and seems doable from the perspective of the Department. We also have broader asks that we would also like to see delivered for the broader group.