Barry Cowen (Laois-Offaly, Fianna Fail) | Oireachtas source

The motion refers to the fact that the number of discretionary medical cards fell from 80,524 at the start of 2011 to 63,000 at the end of 2012 and that, in the first seven months of this year, there was a further reduction of 8,100, which is a monthly average reduction of 1,163. This takes place against a background of obvious increases in eligibility and suitability on the part of many people in society by virtue of the situation in which we find ourselves. Although the situation has reached such a pitch, this is not the first time the matter has been brought to bear in the chamber with a view to addressing and resolving the issues in a manner more in line with what Members find in their constituency offices.

When I consult my office I hear about, and during my regular clinics I meet, a growing number of people who have been reviewed and subsequently lost medical cards. I therefore contacted a sample of those people today to ask their permission to refer to their case in the chamber. Although I have been given that permission - I will use my remaining time to talk about some of the cases - I will not use anyone's real name, but I will make the cases available to the Minister after the debate.

Helen has held a full medical card for a number of years as she suffers from severe rheumatoid arthritis and attends St Vincent's Hospital regularly. Her application came up for renewal in April and was refused. We requested a review, but it was disallowed. We then requested an appeal and only yesterday we received word that she was granted a doctors only medical card. This lady is on medication that costs more than €100 a week, which she does not have the means to meet.

Timothy has always held a full medical card on medical grounds as he suffers from ADHD, attention deficit hyperactivity disorder, drug addiction, depression and a fracture to a vertebrae. As he held a card, his three children were also entitled to a card. His card came up for renewal in August, but his application was refused. The case is under review.

Anne has always held a full medical card on medical grounds as she suffers from osteopenia and severe rheumatoid arthritis. Her case came up for review in April. When her application was refused, it went to review but that, too, was refused, and it was later refused on appeal.

Breda has held a full medical card as she has a number of medical conditions and is awaiting surgery on her kidneys and bowel. Her card came up for renewal in August, and she was awarded only a doctor visit card. A review was requested and we await the outcome.

Audrey has always held a full medical card. She suffers from hypertension and is on long-term medication. She attends her general practitioner regularly. Her application came for review in April. It was refused. We requested a review of the decision, but the original decision was upheld. Her case is under appeal.

Kieran always held a full medical card on medical grounds as he suffers from COPD, chronic obstructive pulmonary disease, sleep apnea, heart disease and high blood pressure. His card came up for review in February. His application was refused, and we requested a review, which is ongoing.

Jack is aged nine. He has held a full medical card. He has multiple disabilities, including cerebral palsy and a hearing impairment. Jack's medical card came up for review in February and he was awarded a doctor visit card. We requested a review and the original decision was upheld. We therefore appealed the decision and that was again upheld.

The final case that I will mention in the short time that I have relates to a young lady whom I know. I wrote to the Minister and to the Department on 1 August:

I write further to representations from the above named [We will just say that her name is Jeanette] and further to a phone conversation this morning with [someone] in your section.

I've known Jeanette and her family all my life as she is from [my home town]. [She] was born without lower limbs and has been in a wheelchair all her life. This has not, or never, deterred her as she lived a very fulfilling life [and has continued to do so], excelling in sport and all aspects of community life.

Jeanette works in the HSE ... has always sought not to be an economic burden on the State. She has had and retains her own medical needs which surpass her means, now that she has dependents, namely her partner ... whom is unemployed and her miracle baby [now 12 months old]. [That baby unfortunately] is in constant need of specialist medical attention. All the relevant details pertaining to this case, economic and medical, are on the file.

I find it distressing that this application process has been so poorly dealt with, considering the amount of communication Jeanette has had with the relevant sections dealing with her application.

She was informed over the phone that the cards were granted only to be informed the opposite days later.

It is unbelievable that Jeanette should be forced to avail of my ... office in seeking to have the only decision possible in this case, arrived at.

I don't normally seek to personalise cases in this manner, but I am too well aware of the need in this instance and cannot 'for the life of me' understand how

a) This case has been dragged so long

b) That a medical assessor did not find in favour of this application.

[I asked that arrangements be made] for these cards to be issued or failing that [to make available to me] the full reasoning and methodology at a decision that medical cards are not necessary from a medical perspective.

I did not receive any explanation from the office in question on that decision and how it was arrived at and, unfortunately, the lady in question did not retain her medical card and is just in receipt of a doctors only visit card even though she has a great medical need and does not have the financial means to meet the demands on both her and her child .

As I said, those are only a sample of the cases that are prevalent in all our offices. The sample has grown greatly as the months pass. It is plain for me and my colleagues to see that these issues are not being dealt with in a manner in which we can stand over. I ask the Minister to take a personal interest in the cases that we will forward to him and to find out where the failings are in the relevant sections. Is it the case - I would have doubted very much that it would be the case - a direction has been given? It seems patently obvious that it might be the case.

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