John Browne (Wexford, Fianna Fail) | Oireachtas source

I compliment Deputy Kelleher on the motion he has proposed. The widespread and deliberate withdrawal of medical cards is causing huge anxiety and concern throughout the country. The number of discretionary medical cards fell from 80,000 at the start of 2011 to 63,000 in 2012. As Deputy Kelleher has pointed out, in the first seven months of this year the number of medical cards reduced by between 1,100 and 1,200 per month. I do not doubt that there is a cynical campaign to reduce the number of discretionary medical cards. It is clear from what public representatives across the country are hearing in their clinics that a widespread cull of discretionary medical cards is under way. I could mention many examples of this. I have never received as many representations about medical cards as I received during the first six months of this year. I am sure every other Deputy will say the same. Many people are losing their medical cards. In addition to the withdrawal of medical cards, there are delays in issuing medical cards. People are very concerned and annoyed about this. The Government is continuing to mislead the public by denying that any cuts are taking place in this area. Indeed, the Taoiseach has said in this House on many occasions that there have been no changes in the ground rules or the regulations. He has suggested that everybody who is entitled to a medical card should get one. Obviously, the Taoiseach is out of touch with what is really happening on the ground at HSE level.

Discretionary medical cards are issued on health grounds, on the basis of medical need. Under this Government, thousands of medical cards are being withdrawn because the recipients' incomes are above the threshold. When decisions on discretionary medical cards are being made, patients are assessed on the basis of the seriousness of their illnesses rather than on the basis of their incomes. The Taoiseach and the Minister for Health continuously claim that there has been no change in policy or in the medical card guidelines, but nothing could be further from the truth on the ground. Every public representative has seen evidence of a widescale programme of cuts that is hitting very sick children and vulnerable families that are under enormous pressure. As I have said, we have been inundated with representations from people whose medical cards have been revoked even though they have a clear and undeniable medical need. It is very concerning that families facing severe health and medical pressures are having to deal with the withdrawal of medical cards. As I said, the number of discretionary medical cards has decreased by more than 20,000 since 2010. This seems to give the impression that everyone who had a medical card has suddenly been cured and no longer needs the card, which shows the cynicism of this Government at present.

If the Minister does not want to believe what we are saying, I remind him that Emily O'Reilly recently said that cutbacks are being implemented by applying “the letter of the law” and removing the element of discretion that previously applied. According to the Irish Motor Neurone Disease Association, discretionary and emergency cards are not being given to people with the condition, which is terminal. I have given two examples of independent voices that support what we are saying. The Jack and Jill Foundation, which does tremendous work for children, provides direct funding to the families of children with brain damage to enable them to purchase home respite care. The foundation says that as a result of these recent changes in this area, it is impossible to get medical cards for children at present. The comments of these three independent groups about the withdrawal and removal of discretionary medical cards are at variance with what the Taoiseach and the Minister for Health are saying.

Deputy Sean Fleming spoke about the treatment of cancer patients, which is causing grave concern. Over the years, regardless of the Government that was in power or the Minister who held the health portfolio, medical cards were issued to cancer patients until such time as they no longer had the disease. Medical cards are no longer being allocated to cancer patients on medical grounds. Instead, all kinds of income and finance obstacles are being put in their way. The HSE has said that it issues medical cards within 24 hours, but I can refute that by referring to the example of a person whose family applied for a medical card three weeks ago. I have seen the letter sent by the consultant from the hospital where the person is being treated, which makes it clear that this is an end-of-life situation. Three weeks on, that person has not been issued with a medical card. I have been contacting the medical card section of the Department on a daily basis. In fairness to the official in the section that deals with Deputies' inquiries, he has been very helpful and supportive of my efforts to find out why this medical card has not been issued. All kinds of information, including insurance policies, proof of income and details of farm premium payments, has been sought from this person's family even though the consultant has said this is an end-of-life situation. It is obvious that medical cards are no longer being issued in such circumstances.

Medical card reviews are also causing consternation, particularly for older people. Old age pensioners who were issued medical cards with expiry dates of 2014, 2015 or 2016 have come into my clinic to tell me they have received letters from the medical cards section of the Department to tell them that a review is being carried out. I cannot get the HSE or the people who issue medical cards to explain why this is happening. They just say they were told to seek a review, even though the medical card holder expected to have the card until 2014, 2015 or 2016. I ask the Minister to find out why this is happening to old age pensioners whose circumstances have not changed. The Minister, Deputy Burton, keeps telling us she has not reduced the old age pension, which is fair enough, but she has not increased the pension either. It is not as if a pension increase has caused these people to fall outside the medical card limit. The Minister needs to give serious examination to these areas. The discretionary medical card system must be reintroduced. Old age pensioners whose circumstances have not changed should be left alone, rather than being pressurised. Old age pensioners should not have to send in their pension book numbers again when no changes have taken place.

We are spelling out clearly that we have major problems with the manner in which discretionary medical cards are being issued. As I mentioned, the same point has been made by the Irish Motor Neurone Disease Association and the Jack and Jill Foundation. Emily O'Reilly, who is the most independent person in this country, has been continuously saying that the HSE is withdrawing discretionary medical cards from patients who are seriously ill and suffering from cancer, stroke or heart problems. These people have enough issues to be dealing with - family circumstances etc. - without having to face the pressure of having to reapply for a medical card and worry that the application might not be allowed. I ask the Minister to give serious consideration to this situation. All of the issues we have raised tonight need to be clarified and changes need to be made to ensure the discretionary medical cards to which people are entitled will be re-issued as quickly as possible.

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