Joe Costello (Dublin Central, Labour)

The medical card is a matter of life and death for many people. Not having a medical card can have a very serious effect on a person's health. The changes the Minister introduced recently with regard to the medical card, the general practitioner, GP, card, the centralised system for processing renewals and fresh applications and the new prescription levy for medical card holders have added to the confusion and delays in the system. Why is it the case that the health system, above all else, has constant delays, queues, confusion, bureaucracy and waiting lists? It is almost as though it is a purgatory which sick people have to endure before they are able to access medical care and their rights. I find that many more people have come to my clinics in recent months regarding medical cards than I ever experienced before. Much of that is a result of the new changes the Minister introduced.

The situation is very depressing and worrying for people who have difficulties with applications and renewals. The current system is such that it can take months to process them. There are regular requests for additional information. The official average time for appeals is now two months. Documents go missing on a regular basis. The elderly and the chronically ill suffer most and they have immediate needs which should be addressed. A centralised system now operates on the north side of Dublin in a compound that is worthy of Fort Knox because it is impossible to get in and out of the place. It created a bureaucracy that results in everybody being put on the same conveyor belt when a local system with local information and local knowledge would produce instant results.

In addition, the system does not do what is supposed to do, namely, provide a level playing field. Rather, it discriminates against the elderly and chronically ill as they are most likely to have difficulty with filling out the application, renewal and appeal forms. The Minister must realise that she is dealing with the most vulnerable of citizens. An application processing system should reflect that rather than creating a centralised bureaucracy and pretending that all is well.

See this speech in context