Éamon Ó Cuív (Galway West, Fianna Fail) | Oireachtas source

I am delighted to have an opportunity to speak on the motion and also on the Government's amendment. We are asked to note that there has been no change to the manner in which discretionary medical cards are awarded. That does not stand up. I have cases in my constituency of people with very severe disabilities who have had medical cards for many years and who suddenly find they have been withdrawn. I had one extreme case - I do not wish to go into the details because it might identify the person - where I was utterly shocked that the medical card had been withdrawn. A colleague of mine from the Minister of State's party in my constituency and I worked on this issue. When we became aware of the circumstances of the case we contacted the medical card section and were advised to appeal. This has been going on for many months and no card has been granted.

If the Minister of State is interested in the case, I will provide, on a confidential basis, the circumstances of the case and he can check out what I have said. If anything, he will find that I am understating the position. I can understand on a review how a mistake might be made. However, I cannot understand, given that the evidence we have provided was so thorough and overwhelming, the reason, months later, the card still has not been granted. I checked today with my assistant in the office if it was her impression and clear understanding that cards are being withdrawn where they had been granted in the past on medical need. She said that is what is happening.

It is correct in some cases when one makes the case and goes through the process that one wins the appeal. This is happening in many cases but it is putting a huge strain on people to get evidence that is already available to the HSE.

It seems to be a pattern with this Government so there is no point in blaming the HSE for this. The Minister of State's party colleague, the Minister for Social Protection, is constantly throwing people off invalidity pension who have been on it for years. Where we produce all the medical evidence and go to appeal, in the vast majority of cases and after a slow process - the process is slow rather than there being a lack of evidence - the person then wins the appeal and gets the invalidity pension back. There seems to be a process of believing that people who have been given either an invalidity pension or a medical card based on medical need for a long time no longer need them. It seems to be hitting people who often find it quite difficult to get the evidence together - not because it is unavailable but because it means going to doctors and getting a lot of paperwork together. Due to their disability, these people can find difficult what we do as our daily work. This puts a lot of pressure, including mental pressure, on them.

I do not understand the logic behind this approach. If one takes all the people off invalidity pension and puts them on jobseeker's allowance, the saving is minimal. In a very competitive work market, the chances of those people getting employment if they have been on invalidity pension for 15 years are next to nothing when we already have a market that is overcrowded. What seems to be happening with the medical card is not just an isolated "one issue" matter but a pattern that is being followed by the Government and Labour Ministers to try to make savings. It is not a fair way of doing it.

There are rumours circulating that the Minister of State will give every child in the country under five a medical card, which is very attractive. It does mean that parents earning €200,000 per year will be granted medical cards and at the same time, there is a vendetta against those who most need them based on medical grounds. This is a very serious issue. It is a matter of hitting the weak and vulnerable and putting huge strain on people because it is creating uncertainty about the future. I accept that the previous Government made a mistake when we granted medical cards to everyone over 70 because of the cost factor. However, it was right of us to say that once a person reached 70 and received a medical card, there should be no further review of the card. There is an argument that in straitened times, one cannot give cards to people of very great means - unless one is to give cards to everybody in the country - and have families struggling on low means and no card. I have always been of the view that somewhere in the higher echelons, there is an argument for saying that the universal provision of anything like a medical card must be at the expense of somebody else because there is only a finite amount of money and it inevitably is at the expense of struggling families who are earning a bit of money and are just over the threshold.

Where somebody with a significant disability is given a card and their income is very unlikely to change significantly if they are a pensioner, it should be left and not reviewed. Before the general provision of medical cards for older people was introduced, the problem was not with taking the card from them, rather, it was the review and the strain, stress and worry the person suffered in trying to get the bits of paper together to deal with the review and in wondering whether they would get the card back. Even when somebody like myself would have said on looking at their circumstances that they would inevitably get it back and that there was no need to worry that did not take away the worry.

There needs to be a change of attitude. We need to go back to the much more humanitarian processes that were in place in the past where we dealt with real people who had a good idea about the people to whom the cards were granted rather than these so-called fair procedures that are so far removed and that try to judge everything on a bit of paper without ever having met the person about whom a judgment is being made.

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