Michael Moynihan (Cork North West, Fianna Fail) | Oireachtas source

I compliment Deputy Kelleher for tabling this motion. I have had considerable amount of experience over the past 12 months, particularly this year, in dealing with discretionary medical cards. In one case, I set about getting a medical card for a person who had been diagnosed with terminal cancer and who needed immediate hospital care. Documentation came back to us about a small private pension of some €67 per month. As we were working through it, the cancer was found to be more serious than had been anticipated and the person died without the medical card being approved, even with a letter from the consultant stating that the cancer was terminal. I got on the telephone over several days to explain how serious the case was to the medical cards section and yet we still received what I can only describe as tripe from the section. I remember when another e-mail came back looking for some form of clarification. At that stage I knew how serous the situation was for the family. I had to go look again at the process and ask relatives to go through paperwork to find what the medical cards section was looking for.

The simple notion that there is no change in policy is irrelevant. I do not think there is a Deputy, Senator or public representative in any part of this country who would not accept privately, although maybe not publicly, that there is a change in direction in respect of the medical card. We have seen people, particularly children with special needs. I have met an adults their thirties with special needs. There is always concern on the part of parents about long-term care. The medical cards section questions a woman who may never have had earned income for herself and checks the income of retired parents.

There is a change in policy in this area. The basic human effort from the medical cards section must relate to where there is overriding medical need. I am talking about the cancer patient, not about somebody who is way over the limit financially. I am also talking about retired people of modest means who have not yet reached the age of 70. The only thing that should be accepted here tonight by all sides of the House is that there has been a change in the policy that must be reversed.

That is universally accepted. The official line may be that nothing has changed but the simple fact of the matter is that the policy has changed and it is causing undue hardship to families facing serious illness. Most families have come face to face with illness at some point. Such families are extremely vulnerable and they will accept whatever help they can get from the State. The illness may involve a child, someone with profound disabilities since birth or a person who has recently been diagnosed with cancer. The Government should simply accept the motion. We can have our spats but people are suffering unnecessarily because of this change in policy. They have enough to contend with already.

This morning reference was made to a letter from a consultant. This is what the HSE requires at present. A GP's letter counts for nothing. Some of the people in the medical cards section are doing an exceptional job in communicating with us and trying to help people, but they are constrained by policy. They are telling people a GP's letter is no good and that a consultant must write the letter. It can take a long time to get such a letter, however. To public representatives it may appear to be a simple task, but for families that are already under stress because of illness, it is a mountain to climb. We need to be honest with each other and admit that the policy has changed and is causing hardship to those who are most in need of the State's support.

I recently dealt with the case of a 60 year old man who has suffered from progressive multiple sclerosis since he was 32 years old. He had a medical card since his early 40s and he is confined to a wheelchair. Thankfully, his multiple sclerosis has been in remission for the last year to 18 months, but he still needs support for his daily needs. He was accused out of the blue of having a private pension from some mysterious company even though he retired on an invalidity pension. This man and his wife and two adult children would dearly love to have a private pension but they do not know where the HSE got such a notion. This family sacrificed everything to survive on an invalidity pension. If he had been able to work there is no question that he would have done so.

Earlier this year one would have been forgiven for thinking that the changes were being applied on an area-by-area basis. In one part of my constituency people were being asked for further information as part of a review of medical cards. We can discuss the reviews elsewhere but the main reason I speak tonight is the discretionary medical card. It is nonsense for anybody in Government to say the policy has not changed. We have seen cases in which people are over the limit in respect of financial need, but I dealt with a case earlier this year in which the HSE refused to sanction a medical card, even though a consultant had written a letter stating that the individual's illness was terminal, because a private pension worth peanuts had to be examined or a box had to be ticked.

How often does the body established to examine this issue meet? Is it simply a case of carte blanchefor the policy? I urge the Government to reflect on the motion in a humanitarian and realistic way and reverse the policy. It is causing hardship for those with terminal illnesses and profound disabilities. Children have also been targeted on the basis that their parents might have incomes above the limit. Those who have held medical cards for lengthy periods due to the severity of their conditions have suffered enough. Every Member of this House has received representations on this issue. I urge the Government to examine this issue and to tell us the truth about it. The only line I would accept is that the policy has fundamentally changed. It should be changed back.

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