John Browne (Wexford, Fianna Fail) | Oireachtas source

Deputy Buttimer's contribution was interesting. It is a far cry from when he was on this side of the House calling for more money to be spent on health services. Obviously he has changed this tune in this regard. I have been told by many people that the Minister was a caring doctor for the elderly in his constituency but for some unknown reason he has changed his tune in the Department of Health. He does not seem to be able to protect the less well off and the elderly in our society. Over the past few years, prescription charges have increased while the bereavement grant and the telephone allowance have been abolished, DIRT tax increased and fuel allowance reduced. All these changes have had an effect on the elderly.

The Department is no longer in the control of the Minister and that is where the problem lies. It is controlled by the Departments of Public Expenditure and Reform and the Taoiseach, which the Minister more or less admitted at a recent health committee meeting. It is time he regained control of the Department and got on with dealing with health matters in the way they should be. The Title of the Bill sums everything up. Alteration means a reduction in the number of medical cards for elderly people. The legislation will result in 35,000 people losing their medical card over the coming year. This is in addition to the Bill passed last spring which hit more than 20,000 over 70s medical card holders. In total, 50,000 people will lose their medical card over the next year. The Minister said there would be a little discretion between now and January 2014 but that is only six weeks away and, therefore, people will not experience much discretion.

Many people attend or call my clinic because they are concerned that they will lose the card. Some of them will not but many will because of the change to the eligibility criteria. This is causing a great deal of concern and many people are frightened that they may lose their medical card. They are old and in poor health and the card gives them licence to attend a doctor without paying. Those who are slightly above the threshold will lose the card and they will have to pay for everything. In some cases, they will get a GP only card but that does not cover the cost of medication, which, depending on the ailment, can be high and can place a major financial burden on the elderly. The Government seems to have a serious dislike for older people given the various cuts it has introduced to their allowances over the past two years and they are causing a great deal of hardship and concern.

Deputy Buttimer touched on the discretionary medical card issue. There has been a major change in the way they are assessed. Up to nine months ago, a discretionary medical card application was dealt with quickly and was granted in most cases on the basis of medical need but that has changed significantly. It is taking months to have a card approved or rejected. When one makes an inquiry, one is told the application has been forwarded to the medical officer for a decision. Perhaps only one medical officer deals with the applications but there are huge delays. I dealt with a case where the consultant stated clearly in a letter that the person was in an end of life scenario but it took months to secure the medical card. That is not good enough. If a consultant's report states the person is seeking the medical card on discretionary grounds because it is an end of life situation, the card should be granted within a week or two at most but that is not happening currently.

That is causing serious problems and hardship for families and the Minister should investigate why it is taking the HSE so long to deal with such applications. It was always the case that if one was suffering from serious cancer, one automatically got a medical card but that is no longer the case. One must now battle with the HSE to try to get a medical card for a person suffering from cancer. It may be very severe cancer and sometimes one might only want that medical card for six or nine months or for one year, depending on whether one is cured or one passes on to one's eternal reward. The delays in issuing medical cards to cancer patients is a serious concern to many families because, as one knows, if one gets word one is suffering from cancer, it causes major gloom not only to the person who gets the message, but also to the family. There is a need to speed up the provision of medical cards to cancer patients.

We have had representations from the Jack and Jill Foundation and many other organisations stating that a considerable number of medical cards are being withdrawn from people with not very high incomes. These organisations represent people with spina bifida and Down's syndrome, for example. The Jack and Jill Foundation and many other organisations are at their wits end trying to provide services for their members. They could do without the hassle of trying to represent families whose medical cards have been withdrawn, despite the fact their incomes have not changed. These areas need serious attention. This change will cause serious problems for 50,000 families which will now lose their medical cards. It is an area the Minister should revisit. He is a general practitioner and should know the position of such families and how difficult it is for them when their medical cards are withdrawn.

I could read out what the Tánaiste, the Minister, the Taoiseach and many Fine Gael and Labour Party backbenchers said in 2008 when they accused the then Government of abandoning old people, even though the criteria for medical cards was a lot more generous than it is now. Now that they are in government, they have changed their tune and want to take more medical cards from such people.

The Minister should take back control of the Department of Health from the Minister for Public Reform and Expenditure and the Taoiseach because they now control the Department. The Minister has no say and he has been told he must cut €660 million. In the past couple of weeks, the Minister for Public Expenditure and Reform said he may have to cut another €1 billion. In all honesty, how can one run a health service when it is a case of making it up as one goes along without any hard and fast guidelines set down in the budget which was always the norm? The budget for every Department was decided on budget day but for some unknown reason that has not happened with the Department of Health and the Minister is trying to hide the fact he is no longer in control and that it is being run by two other Departments. That is certainly not in the interests of ordinary people who depend on the Department of Health and the HSE to provide adequate services for them. Will the Minister rescind this decision to withdraw medical cards from 50,000 people?

See this speech in context