Seán Fleming (Laois-Offaly, Fianna Fail) | Oireachtas source

I thank my colleague, Deputy Kelleher, for raising this important issue of discretionary medical cards which affects many thousands of families. The Minister of State, Deputy White, may say there has been no change in policy but the practice has been changed. I believe there has been a change in policy but it has probably not been written down.

It boils down to the fundamental issue that this Government is focused on cutting expenditure on the most vulnerable people in Irish society. The majority party in this Government has decided, as a matter of policy, that it will not ask those who can make a larger contribution to the running of the country to do so. It has said it will make cuts in respect of people relying on State services, whether people with disabilities, people looking for medical cards, people on social welfare or parents depending on child benefit, and the Labour Party is implementing that down the line. The Minister of State, Deputy White, is in the firing line for this issue which is basically as a result of Government policy to cut Government expenditure on those who need it most in order to protect the well off people who are the main voters of the larger coalition partner in Government. That is why we have most of the difficulties in these areas.

If one looks back over the motions over the past year or two years, most of them relate to cuts in expenditure which this Government has decided to implement, as a matter of choice, rather than increase taxation. It can longer blame the troika as it will be gone. The level of adjustment will be the Government's choice and the breakdown of that adjustment in the budget next week will be a choice between taxation and cuts in expenditure. If the Government follows the practice of the past two years, further regressive steps will be taken in that regard.

I have been struck by the number of people coming to my constituency office about this issue. Every Member will be able to list difficult cases and I will highlight one in a moment. The Taoiseach was asked about the reduction in the number of discretionary medical cards by my party leader, Deputy Martin, on Leaders' Question some time ago. There was a time when if a person had serious cancer, he or she got a medical card as a matter of course for one year or two years until he or she recovered. It may not have been written down as policy but that was the established practice in every part of the country. That practice has now changed. If one has serious cancer, one will be told to go to one's public hospital and one will not get a medical card as a matter of course. The discretionary medical cards have been withdrawn in those situations.

The Taoiseach was pursued on this matter and the frightening comment he made was that people will get discretionary medical cards where their condition is life-limiting. In other words, if the condition one has will make one die sooner rather than later, one will get a medical card but if it will make one very sick and distressed for the rest of one's life, although not shorten one's life, one will not get a medical card. The Taoiseach was specific in referring to cases where the condition was life-limiting. I have said to people that if they have cancer and get a medical card, some consultant must think they are on the way out because the Taoiseach made it very clear that they will only get one if their condition is life-limiting. That is what is behind what is going on. The Minister of State, Deputy White, should not take my word for it but should read what the Taoiseach said. It is fine for him to say there is no policy on this but the practice, as a result of Government decisions, demonstrates otherwise.

I have come across dozens of cases but I would like to highlight one case which came to public notice in County Laois recently. I have the permission of the person involved to use his name in this debate. Mr. Joe Barrett published this article in the Laois Nationalist, a local newspaper, on 1 October 2013. The Minister of State's Department, which scans the newspapers for nice photographs of Ministers when they visit constituencies, should have come across this article. The headline was: "You Couldn't Make This Up". That is how bad he thinks the story is. I will summarise his story which is one of several stories I could relay and is in the public arena.

He stated that after 30 years of receiving a medical card, he was refused one this year. He went on to state that there has been a lot of disquiet since Fine Gael and the Labour Party came into government and cut 24,000 discretionary medical cards and that people who qualified before will only get a card if they require urgent and ongoing medical treatment. The first he heard of it was when he got a GP card. He asked the HSE why he was getting a GP card as he had serious conditions. The Minister of State, Deputy White, cannot outsource this problem to the HSE because the Minister, Deputy Reilly, has abolished the board of the HSE and is taking direct political control of this area.

At that stage, Mr. Barrett decided it was necessary to outline his situation to the HSE. He said that 30 years ago, he underwent a kidney operation and not long after that, he was found to have diabetes. After that, he was diagnosed with high blood pressure and then qualified for a medical card. Fast forward a number of years, and he then suffered a heart attack. Two months later, he had two stents inserted in arteries in his heart and a month later, an artery that had already been stented had to be redone. In the same year, he underwent open heart surgery and received a triple heart bypass. Following that operation, he underwent a heart operation a year later when one of the grafts that was used in the bypass blocked and had to be stented. Over the years, he has been in and out of the hospital in Portlaoise and St. Vincent's hospital in Dublin.

This person was refused a medical card. He stated that in consultation with a cardiac surgeon, he chose not to undergo another cardiac procedure. Could one blame him? During those years, he has undergone six angioplasty procedures and over the years, he has been on various doses of and different medication. He is currently on a daily dose of 14 tablets. On top of that, he is in heart failure but has been refused a medical. Shame on the Minister for Health and the Department who will say there is no policy to review but the practice is otherwise.

Mr. Barrett went on to appeal the situation and wanted to know what medical assessor refused him. He asked for a copy of the file of the medical assessor who reached the decision but he was refused it. He was told he could apply to get his own medical information under freedom of information. Talk about trying to deal with a member of the public properly. He submitted an appeal but in the meantime, he is seeking review from the HSE as to why he was refused. He will then be told he can appeal again. In the meantime, he does not have a medical card despite those conditions. That household has several other conditions which would back up the need for a discretionary medical card. That is one example on the public record. One might say the man is not going to die so he does not require a discretionary medical card.

I have good personal regard for the Minister of State, Deputy White, who I believe is sincere. He has gone into a Department in which he wants to make progress but he must get on top of the situation where his Department is cutting back on discretionary medical cards for people who have these medical situations.

I highlight cancer cases, in particular, because years ago, people got discretionary medical cards as a matter of course for the year or two years for which they required them. I referred earlier to daily medication. The prescription fee has been trebled from 50 cent to €1.50 per item.

That is now costing many households up to €10 a month. They are having difficulty finding this additional cash. Regardless of whether the Minister classifies this as a policy or as a practice, the reality is that it is happening on his watch and he is responsible for it. People are suffering as a result of the deliberate policy of removing people from the system. A similar approach is being taken in the Department of Social Protection, where disability and invalidity payments are being withdrawn from people. The same policy is evident in the medical cards section of the Department of Health. People are having their medical cards taken from them and their cover is being reduced.

The journalist I mentioned concluded his article by saying he wrote his appeal at 3 a.m. He does not know where it is going next. He is "worried sick" because he cannot cope with the stress he is under. He says that this worry is adding to "my cardiac conditions" and "starting to affect my family". The Minister's answer is to tell him he is not entitled to a medical card. It is shameful that the Department is acting in such a manner.

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