James Reilly (Dublin North, Fine Gael)

I move amendment No. 5m:

In page 6, before section 5, to insert the following new section:

"5.—(1) Notwithstanding any provision of this Bill, any person the subject of undue hardship or terminal illness, may apply to the Health Information and Quality Authority for a recommendation that they be issued with a discretionary medical card.

(2) The Health Service Executive shall issue a discretionary medical card to the applicant within 4 weeks of a recommendation under subsection 1 being made.".

The rationale behind this amendment is to address the situation whereby the Health Service Executive functions as both assessor and provider in the case of applications for a discretionary medical card. It is akin to being both gamekeeper and poacher. In the interests of independence, fairness and transparency, these assessments should be undertaken by an independent entity. As I have said before, I object to the introduction of means testing in respect of applications by terminally ill persons. Such individuals have done the State some service and now have six months or less to live. They should receive a medical card as of right without having to deal with red tape.

Notwithstanding that, and in view of current economic circumstances, I ask the Minister to accept my amendment so that such persons can at least be confident that their case will be assessed by an independent assessor. This does not require additional manpower because the Health Service Executive staff currently employed in this work can be transferred to the Health Information and Quality Authority where they would be at arm's length from the executive. If there are financial implications for the latter, it is possible it will take a certain view of such applications. I am not accusing anybody of wrongdoing but if somebody is undertaking an assessment the outcome of which may involve a cost for his or her organisation, there is bound to be an element of conflict. I hope the Minister will accept this amendment. I am sure she has 100% faith in HIQA, as I do.

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