Ciarán Lynch (Cork South Central, Labour) | Oireachtas source

I thank the Ceann Comhairle's office for allowing me to raise this matter today. I also thank the Minister of State, Deputy White, for coming to the Chamber to respond to it. I wish to propose a minor alteration to the medical card review process. This modification would have no cost, would improve the notification system and would make life much easier for a substantial group of vulnerable people.

When medical card holders are selected for review they are written to and requested to complete forms in order to establish their continued entitlement to the medical card. If they cannot establish that entitlement they are cut off and the system is as simple as that. However, a problem arises with a substantial cohort of people, who are clearly entitled to hold a medical card under the present arrangements, but who for one reason or other fail to return the review forms to the satisfaction of the PCRS.

As the onus is on the cardholder to update the Health Service Executive, HSE, about a change of address or other circumstances this frequently causes difficulty. I will cite some instances with which I have dealt in my office. In all of these cases the people were solely dependent on social welfare income. There was no bar to the renewal of their medical cards. The first instance was an 80-year old man and his 73-year old wife who were cut off because they did not return the forms. They had moved house eight years ago and their new address had never been conveyed to the processing system even though they had visited a doctor and pharmacies regularly during that eight year period. This couple lost their medical card cover abruptly and were refused their monthly prescription. Once the review forms were conveyed to the primary care reimbursement service, PCRS, they were reinstated.

The second case concerns a gentleman who suffers a rare condition, Buergers disease, as a result of which he has had multiple amputations on his hands and feet. He is wholly dependent on the kindness of others and failed to return the forms in the allocated time. This gentleman lost his card cover, was refused prescriptions but has since been reinstated. The third case was cited by Dr. Brendan Crowley in a recent letter to TheIrish Times. It concerns an 84-year old woman with Alzheimer’s disease who was unable to arrange to have the forms completed and returned in time. This lady lost her medical card cover for a period but it has been reinstated.

The final case concerns a couple with two adult, intellectually challenged, dependent children. In this instance the forms were completed and returned in the prepaid envelope supplied but the PCRS did not receive the forms. The gentleman rang to check that they had arrived and fresh forms were sent out. These were completed and inserted in the prepaid enveloped but again the PCRS did not receive them. The application was eventually e-mailed from my office and receipt was subsequently acknowledged. This couple had been without medical card cover for some months but thankfully as of last Monday the card was restored because they qualify on medical and income grounds. I am sure that every Member has encountered situations such as this whereby people who do qualify have lost cover through some disruption in the application process but the cover has been restored.

I have a very simple proposal. At present a general practitioner, GP, is notified that the card is due for review and may be cut off. I propose that the pharmacist who filled the most recent prescription should also be notified of the pending review and its possible consequences. Every patient in need of medication must make contact with the pharmacist at least monthly in person or through a representative and the pharmacist is directly concerned with ensuring that the patient has the correct medication and is ideally placed to assist the patient in completing a review.

All that is required is that electronic notification be given to the pharmacist who last dealt with the patient stating that the patient’s medical card is up for review. It could even be a docket that would be inserted into the prescription bag. The patient or the person caring for the patient-----

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