Jonathan O'Brien (Cork North Central, Sinn Fein) | Oireachtas source

I am sure the Minister of State, more than anyone else in this Chamber, has people coming into his constituency office about medical card issues. No Deputy can say that in the last three years nobody has attended their constituency offices to inquire about a medical card application or the withdrawal of a card as part of the review process.

I turned on the radio while driving yesterday and got the end of an interview. I am not sure whether the speaker was a departmental official or a journalist speaking about discretionary medical cards. At the end of the interview the speaker said that, according to the Department of Health, anyone who is in receipt of a discretionary medical card and is currently undergoing a review process will not have that card withdrawn as long as they are in correspondence with the Department. The Minister of State might be able to clarify whether or not that is the case. If that is the official policy from the Department, it is not what is happening on the ground. I know of cases where people are in receipt of a discretionary medical card and were asked to take part in a review. The review went on for so long, however, that they received a letter stating that their medical card was being withdrawn at the end of the month.

One case that has come to the attention of my office concerns a woman with spinal cancer. She had a medical card but was called for a review. She submitted documentation on her condition, outlining all the expenses associated with it. When she went back to her consultant last month, she was informed that she now has brain cancer. She returned from the hospital having got that devastating news, only to find the letter from the HSE stating that the medical card was no longer valid from the end of this month. I will forward the Minister of State those details. I have already forwarded them to the medical card section and the Minister himself for review.

I have another case of a young girl whose parents are both teachers. While they exceed the income limits, they have a young child with severe difficulties. One of the issues I find disturbing is that when one applies for a medical card or is in receipt of a discretionary medical card because one is over the income limits and it is based on medical needs, and when one takes part in a review, they take into account one's income but not all of the expenditure associated with a particular disability, illness or sickness.

In some cases people are spending enormous amounts of money caring for loved ones, including children and parents, who are sick. I will give an example from my constituency office, which I will pass on if the Minister of State's officials want it. These are the facts concerning a young girl with a rare genetic condition. She is almost three years old but cannot walk, talk or crawl. She cannot sit up unaided and cannot feed herself. She is unable to chew food or drink from a cup. She is completely non-verbal, does not cry and has no way of expressing her own basic needs. She is attending numerous doctors and specialists, including neurologists, eye specialists, respiratory specialists, paediatricians, dieticians, physiotherapists, occupational therapists and speech and language therapists.

Given that list, the Minister of State will be aware that her care needs are extremely high. She also has other issues concerning her arm and hip joints in particular. Any slight increase in body temperature can lead to seizures of up to 40 minutes for that young girl. Because of all those conditions and the ongoing nature of her illness, it is impossible for her parents to ascertain the future medical costs of caring for that child. However, that particular child lost her medical card. She is not up for review and the card was withdrawn before Christmas on the basis that her parents exceeded the income limit.

I know of another young girl, aged 11, who has CP. Her case has been raised here publicly in the past. She is one of only six people in the world with this particular type of syndrome. She is severely intellectually delayed in addition to being visually impaired to the extent that she is blind. She is deaf in one ear, non-verbal and has movement delays. At the age of 11, she is still in nappies.

Doctors have issued letters of support concerning her ongoing medical requirements. In one such letter, the doctor stated that the medical requirements for this young girl are over and above that experienced in the normal population. She had a medical card for ten years, from June 2002 to 2012, but it was then withdrawn. Her parents appealed it but the appeal was denied. If anything, that child's condition has worsened, yet the medical card has been withdrawn from her on the basis of income and that there was not enough medical evidence to support the application to grant a medical card on discretionary grounds.

Her father submitted payslips stating that he was over the income limit. He earns €636 a week.

The mother receives a carer's allowance of €900 per year. I spoke to them today and although the child's total annual medical costs alone exceed €10,000, they cannot get a medical card. It is beyond belief. I do not think the Department knows the true story of the issue on the ground. There are stories and evidence, and I am sure the Minister of State has them in his party. The Fine Gael backbenchers recently raised it with the Minister for Health, Deputy Reilly, at a parliamentary party meeting. People rely on discretionary medical cards to provide proper care for their loved ones.

Some people with terminal illnesses cannot get medical cards or have had their medical cards withdrawn. There is no such thing as recovering from a terminal illness. If anything, one's condition will worsen until one passes away. I do not know whether the Minister of State has ever cared for a terminally ill person. I have, and many other people have. The last thing a carer needs is to worry about how he or she will cover the cost of caring for the loved one. A carer does not want to run up and down to doctors getting letters outlining his or her loved one's condition to support a medical card application because the medical card assessor's letter has said the patient's medical condition does not merit a discretionary medical card.

We have come through a very difficult period economically during which the State lost not only its economic sovereignty, but its compassion and respect for the most vulnerable in our society, particularly our sick people. If anybody needed evidence of that, it is in the withdrawal of discretionary medical cards. The Government cannot justify the revocation of discretionary medical cards from people who clearly need them. That is a damning indictment on our society and this Government.

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