Ann Phelan (Carlow-Kilkenny, Labour) | Oireachtas source

I welcome the opportunity to contribute to the debate on what is a fundamental issue for all of our constituents. I wish to preface my remarks by observing that just because people sit on the Opposition benches does not mean they have a monopoly on concern. I am equally concerned about the people I represent in my constituency. Just because those to whom I refer are sitting on the benches opposite does not mean everything they do is good. I am of the view that this matter is so important that people should not try to score political points in respect of it. We are discussing people's health and I do not like individuals to play politics with that issue. I thank the Minister for acknowledging the fact that people are not being deliberately targeted. This matter is being spun in such a way as to make it appear that we are deliberately trying to take away people's medical cards. Nothing could be further from the truth.

I admit that some people are falling through the cracks. There is no doubt about that. However, the majority of those with whom I deal have their medical cards returned if they supply the information requested by the PCRS. I also admit that work must be done in respect of certain individuals who find themselves in extreme ill health. I communicated this fact to the Minister and he has replied that he is intent on resolving the matter.

There are some facts that cannot be ignored. The population of this country is a mere 4.5 million.

Some 1.8 million people are now in receipt of medical cards. That is a fact no matter what way one does the sums and it is an astounding figure. Medical cards are not free and a certain amount of money has to be paid to GPs for servicing them. People tend to ignore facts but I tend not to do so.

I agree with Deputy Buttimer who said that the PCRS ensures all applications are assessed in a fair, equitable and transparent manner and that it is not under political patronage. I welcome the fact it does not involve what he described as the nod and the wink of perhaps a Fianna Fáil person. It did not matter how sick one was or what one's income was but who one voted for was what mattered, which was a disgrace.

All applications are assessed in adherence with the HSE national assessment guidelines which ensure the €2 billion spent annually on the medical card system is as cost-effective as possible. I do not believe anyone would argue with that. It must be cost-effective in that we must know we are getting value for money. There have been significant improvements in the system in terms of efficiency and overall delivery of service, in particular in respect of the delivery of service on an emergency basis and on discretionary grounds where undue financial hardship is involved.

There are still some people who fall through the cracks, which I admitted earlier. Currently, the system dictates that where an individual and-or his or her family is experiencing undue financial hardship as a result of an ongoing medical condition, he or she may qualify for a medical card on a discretionary basis. While this is commendable, we could go one step further. Why should financial hardship take precedence when assessing an individual for a discretionary card? Personal hardship should also be taken into account as it certainly applies in some circumstances. We all have examples of such people.

I do not envy the Minister of State. This situation is not of his making. We inherited a very difficult situation. As a result of the economic situation, people are coming into the medical card system all the time. There is a cost to that, which must be met. Perhaps we could do some re-balancing of the medical card system in respect of young healthy individuals aged between 18 and 25 years of age who become unemployed but who never need to go to the doctor.

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