Terence Flanagan (Dublin North East, Independent) | Oireachtas source

I thank the Ceann Comhairle for this opportunity to contribute to this debate. I share the concerns expressed that the new criteria announced in budget 2014 can be seen as discriminating against older married couples, as Deputy Timmins stated. Until now the medical card income limit for a married couple was always twice that of a single applicant. Under the new terms, the limit for a married couple is less than double that for a single person, namely, €500 for a single person and €900 for a married couple. This marks a huge decrease in the income limit for a married couple of €500 per week, when one compares the figure with the income limit of €1,400 per week at the beginning of 2013 versus the new limit of €900 on a gross weekly income limit. The Minister advised me, as he did other Deputies, that the reason for this is that "the Government recognises that the living costs of an individual living alone are more than half the living costs of a couple living together and that expenditure does not necessarily diminish relative to the number of people in the household". I have concerns about that statement in that when one half of a married couple dies, there is no reduction in the outgoings of that household except for a reduction in basic food costs. The surviving husband or wife still has the same fixed household costs such as electricity, the property tax, television licence, home insurance and so forth. I ask that the Minister would set out the data that were used by the Department in reaching this conclusion and if those data have just become available or if they were available in the past, the reason they were not taken into consideration in the past.

I welcome the moves in this Bill to improve medical card probity measures to ensure those who are no longer entitled to a medical card or a have a medical card in error and their situation has improved will no longer receive one at a cost to the State. I do not believe that anybody wants to see wastage, particularly in terms of people getting a medical card who do have a desire or a need for one. The Minister has provided reassurance that those entitled to medical care and who have a genuine case and need because of financial hardship will get a medical card. Those who no longer are eligible for a medical card as a result of changes will be entitled to a GP-visit card, and that provides peace of mind for senior citizens. Many people have been scared, uncertain and worried as a result of media reports about the new measures. I hope the reassurances provided by the Minister to address people's fears are solid. The worst concern is fear itself, especially for older people, and we must be careful of that.

Another commitment given by the Minister is the roll-out of free GP care for all citizens, and that remains a priority for Government. We know that the cost of attending a GP and paying for a prescription is much higher in this country relative to other countries, particularly for families whose members are sick and need to visit a doctor. Some such families are no longer attending a doctor as a consequence.

The commitment of the Government to the roll-out of free GP care will help those hard-working families to be in a position to attend a GP when in need. Approximately one half of the population will have access to free GP care by the end of next year. It is important that the Government continues with its reform plans to ensure that a fairer health system is accessible to all. I welcome the introduction of the free GP card for children aged under five years which will go some way to lessening the financial burden of hard-pressed middle and lower income families. A total of 240,000 children are expected to benefit as a result of this new measure. However, I am concerned about the discretionary medical cards. There is a fear that the Department of Health is clamping down and people with terminal illnesses may not be entitled to a medical card. Other Deputies have voiced this concern. It is hoped that genuine cases will be dealt with in a humane manner and that the medical card will not be taken away.

I am concerned about the aspect of data-sharing between the Department of Social Protection, the PCRS and the Revenue. Are there any plans to enable data-sharing between the PCRS, the Department and Revenue to speed up the application process, to improve efficiency and to avoid complications, considering the large volume of applications for medical cards in recent years? I ask the Minister of State to comment on the current relationship between the PCRS, the Revenue and the Department. Are service-level agreements in place?

I understand that the HSE has endeavoured to undertake a communications campaign to inform people of the changes in eligibility. Any moves to improve communication with clients is welcome. I note that the PCRS plans to be aware of the use of language in its letters being sent to clients. This is very important in light of what happened with the Revenue and its methods for communicating about the local property tax. Lessons must be learned to ensure that the wording of letters is more clear and considerate of people's situations. I have a concern about the poor communication from the HSE about the long-term illness scheme. Twelve illnesses are covered under the scheme, including MS, for example. Many of those who apply for medical cards are already covered under the scheme and this needs to be publicised better by the medical profession and by the HSE, so as to cut down on duplication of medical card applications and so that time and money is not wasted in processing unnecessary applications. The same point can be made about the drugs payment scheme. I ask the Minister of State to comment.

I will take this opportunity to highlight my concerns about the accident and emergency department of Beaumont Hospital in my constituency. The national target for accident and emergency department waiting times is that 95% of patients must be treated within a six-hour period once they present to the department. The national target is for 100% of patients presenting at accident and emergency departments to be treated within nine hours. However, Beaumont Hospital currently treats only approximately 70% of all new unscheduled patients within nine hours, thus falling below the national target by 30%. Could the special delivery unit focus its attention on accident and emergency departments in general and on Beaumont Hospital in particular, before the winter season begins?

I have been advised by the HSE that the number of patients waiting on trolleys in the Beaumont Hospital accident and emergency department is a systemic problem and is regularly in excess of 100% capacity. This is as a result of the delayed discharges from hospital wards. Could the Minister of State investigate this situation? There has been an increase in prescription charges over the years. I hope this is not a revenue-generating policy from the Department, although it possibly is such. The limit of €25 could be looked at because it is a lot of money for elderly people.

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