James Reilly (Dublin North, Fine Gael) | Oireachtas source

On the Deputy's final point, the HSE has guaranteed me that people will be approached three months before a review to advise that one is due and that further details may be required.

On the individuals to whom the Deputy refers, I would like to have their details privately so that I can examine their cases. I do not believe there is anybody in this House who wishes to see families who already are bearing the burden of ill-health or life-long disability subjected to unnecessary distress. That is certainly not what I, as a doctor or a Minister, want to see. I would like to see a situation whereby if medical cards are selected for random review and a desk-top study reveals that the person's situation is unlikely to have changed because he or she has a life-long condition, terminal illness, renal failure or other such problems which are unlikely to have improved, they will be set aside until the regular review is due. I will raise that matter with the PCRS and the Minister of State, Deputy White.

We do have to audit our system. If we did not, the Deputies across might not be the first but they would certainly be among those who at the Committee of Public Accounts would hold me to account for not guarding scarce public resources and ensuring they go to those who need them most. We know that we have a lot of need in our society, that we need to bring fairness and equity to the system and that in the past people in some parts of the country could get medical cards based on very loose criteria while those desperately in need in other parts of the country could not. As stated by the Chairman of the Joint Committee on Health and Children, Deputy Buttimer, in the old days in certain parts all it took was a telephone call and a representation and a person got a medical card. That is not fair.

We want equity in the system in so far as we can. We want consistency of approach. I believe in discretion. Not long after I became Minister I asked the PCRS to set up a team of doctors to ensure that there was a medical input in terms of discretion. They do their best to ensure that people who have life-long conditions, disabilities and other serious conditions that are unlikely to improve are given medical cards. Even those who may now have a poor outlook but may improve in six months or a year's time with new treatment, etc., get the benefit of the doubt in all cases. That is what we try to achieve. In any system of the size of the PCRS, with almost 2 million people on medical or GP visit cards, people will fall through the cracks. A good system should try to catch them. This Chamber is another avenue in which to highlight those cases. I welcome when cases are highlighted so that I can look into them and ensure that all matters have been carried out in a way that allows those who are most vulnerable in our society to get the most help and support that we can give them. That is the purpose and function of the health service.

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