Dessie Ellis (Dublin North West, Sinn Fein) | Oireachtas source

Táim an-bhuíoch labhairt ar son an PMB seo.

The past few years has seen chronic and constant confusion with regard to medical cards. Many of the cases that I have come across in my constituency have defied imagination in terms of the reasons given for the refusal to grant their medical cards. We are witnessing a startling fall in the number of persons who are granted or retaining discretionary medical cards. My constituency office has been inundated with medical card refusals over the past year and each one of these refusals not only comes with a heart­breaking story but places a considerable amount of trauma and pressure on an increasingly vulnerable section of the community. The Fine Gael- Labour Government is now implementing the policies of Fianna Fáil which those parties so vehemently opposed when they themselves were in opposition.

The Government must immediately reverse the cuts to discretionary medical cards and ensure that the HSE begins to treat all those who apply for medical cards with the respect and compassion that they deserve. Burdens imposed by medical conditions, illnesses and disabilities must all be taken fully into account, with qualification not simply based on income. We are calling on the Government, in extending free GP care to all, to do so on a programmed, time-tabled and transparent basis and in such a way that no-one entitled to a full medical card under the current rules will lose any of the services provided under the card in the context of a free GP care-for-all system.

Many who have depended on discretionary medical cards have not retained their cards, and many others who were hoping to receive their cards will not be doing so during the course of this year. In our alternative budget, Sinn Féin provided for the extension of free GP care to all children aged five and under without depriving anyone else of their medical card entitlement. This is the fair thing to do. The current medical card eligibility system is in urgent need of replacement. It, like so many other aspects of the State, is not fit for purpose.

I am a proud republican and I believe in a real republic. As republicans, equality is at the heart of all that we believe in and we strive for this every day in the course of our work and activism. We believe in a new republic, a republic where all citizens are equal regardless of the colour of their skin, their religious beliefs, their sexual orientation, where they live or what they do, and in which all citizens have equal access to the services that they need. Any genuine republic will be judged upon how it treats the most vulnerable and those who are most in need of being helped and for this sitting Government, the conclusion reached will not be a good one.

The withdrawal of medical cards from the sick and the elderly is a stain on this State. I would like to cite a number of examples of cases that have come to the attention of my office recently.

A cancer sufferer, a multiple sclerosis sufferer or a person with Parkinson's disease will not get a medical card if their income exceeds the threshold. The current threshold is €184 for a single person and €201 for a couple. The basic rate of social welfare is €188 for jobseekers. A discretionary card may be granted where one can prove that the absence of a card is unduly burdensome or will cause hardship. This is difficult to prove, however, as there are many debts and bills that are not taken into account such as the household charge, utility bills, debts and loans. In addition, there are extra costs to do with illness that are not on prescription, specialist food one may need for an illness, wheelchairs, stair-lifts and physiotherapy.

I wish to mention a number of examples of cases I have dealt with recently. An 82-year-old woman living alone with huge debts due to personal family circumstances, with a medical card valid until 2016, was sent a review form last week. This woman will now lose her card as she has a private pension. Over 70s medical cards are assessed on gross income, not net income, so the tax she pays to Government on her pension is assessed as income so this puts her over the threshold of €500. This woman worked from the age of 14 to 78. Over 70s are assessed on their gross income so what they pay in tax, pension levies and USC are all assessed as income, even though they are not income but outgoings paid to the Government.

A man who worked for 40 years in a factory, reached 65 years and got a pension of €18 a week from the factory now has to pay €750 per annum for hospital visits and €144 per month for medication purely because he was unfortunate enough to get a pension from his job, which he cannot return or cash in. I have a hundred of examples like this.

There are many situations where people are no longer taking their medication as they simply cannot afford it. They are cutting back on inhalers, they are not paying their house insurance, they do not have enough to eat, or do not eat the proper food with ailments such as diabetes.

The lack of a medical card will have huge consequences for health services in future as people are not taking their medication and their health is deteriorating as a result. They are not eating properly and are suffering from huge stress and worry. Old people are living in fear of getting sick. Doctors say there is little point in prescribing medication as people can no longer afford it. Worst of all, people are dying with stress and worry due to the absence of a medical card.

We want to see GP care for all. The provision of a public health care system is a principle we hold dear.

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