Dr. Tony Cox:

On access to a medical card, I practise in County Clare. As the Senator is probably aware, a Traveller health needs assessment was published in July of this year. Some 99% of the Traveller community has registered with a GP and 98% has a medical card, which is encouraging. However, it is not just about having a medical card; it is about accessing services and turning up for healthcare, preventative services and acute services.

In that same report, it is detailed that 83% access care with their GP even though 98% have the medical card, only 57% attend hospitals and less than 5% attend the mental health services. Therefore, it is not just about having access to the medical card, but we would agree that all members of the Traveller community should have medical cards. We have heard the shocking statistics about the mortality, life expectancy and suicide rates. It is just shocking. To think that group of patients in society would not have medical cards would be appalling and we would support all members of the Traveller community automatically having medical cards. Those who do not have medical cards would not be turned away or refused access to services. We all work in an out-of-hours service and we work in our practices and nobody is turned away because they do not have the means of paying for the service. If somebody has a medical need, they will be seen. That is my experience and that would be the experience of all my colleagues. Medical card access is important but access to the services that are available is also important.

The Senator asked if we are doing enough in working with the HSE and in working to address prejudices. I have a son who has started his four years of general practice training. We have a core curriculum in the college, and within that core curriculum we have several learning outcomes that specifically address the problems of the Traveller community. I brought that document in and I could read some of those outcomes to the Senator but we have several learning outcomes such as:

Understand the consulting behaviours of specific marginal groups - homeless, travelers’ drug users, new communities etc... Be aware of cultural diversity between the Irish settled community and those from other cultures... Address prejudicial attitudes and discriminating behaviour that they and practice staff might have towards marginalized groups... Be sensitive to the differing cultural needs of non-Irish patients and travellers.

We have others as well.