Tom Barry (Cork East, Fine Gael) | Oireachtas source

I welcome the opportunity to contribute to this Private Members' motion on medical cards. We need to be cognisant of the fact that this discussion is taking place against the background of our health service which is already costing this country approximately €14 billion. It shows that the Government is committed to health. However, it does not mean that we have a perfect health service - far from it. I deal in my offices in Mallow and Fermoy with medical card applications and reviews for people on a weekly basis, as do all of the other Members present. Dealing with those is not the preserve of any one party; they are an issue and we all deal with them. Currently, medical cards are given on the basis of financial hardship. The primary care reimbursement service is tasked with this job. I must acknowledge their help and engagement because they have a very difficult job to do. The time has come to properly define what a discretionary medical card is because I am not quite sure that I know what it is. We need to address the lack of clarity in this area.

One million medical cards were to come under review for 2014 but this might be a little too ambitious. However, I do not disagree with the principle of a review. We need to review but we need to do it in a manageable fashion. We need to examine new legislation which would allow a third tier of provision for people with grave illnesses. This is not the current position. This is the area where the discussion is developing and I welcome that. Nobody wants to see people suffer, especially people who have grave illnesses such as people on the transplant lists. How can one face a person who is on a multiple transplant list and tell them they cannot have a medical card? I certainly could not do it. We need to have a discussion on where these guidelines should be drawn. We have a duty to explore this area. There will be anomalies but change is always challenging. Transplant patients should be given the support of a medical card, as should living donors, who have donated organs. We are trying to encourage organ donation and it is a very sensitive are. The quality of life enjoyed by people who have received organ transplants is fantastic.

We need to expand the long-term illness scheme to cover other conditions. As the Minister of State said, awareness of this scheme needs to be heightened as many people are not fully aware of it. We must also recognise that we are approaching a threshold with regard to affordability. Some 40.8% of the population have medical cards and 8.8% have GP visit cards. Of the 644,000 reviews last year, 482,000 were dealt with and 96% of those people continue to be eligible. Very few were not found to be eligible. However, with regard to the other 161,992, which is a sizeable number, those people either did not respond or some of them passed away during the term of review.

I disagree with medical cards being tied to other issues such as exemption from exam fees. They have nothing to do with each other and should not be there to muddy the waters - they could be dealt with in other ways.

There are issues with dealing with medical cards at a centralised site. It has removed local knowledge and I am not necessarily a fan of this. However, taking up to eight months to deal with people's reviews is certainly not good enough and it needs to happen in a proper timeframe. If they are not dealt with within that timeframe action needs to be taken. There are also issues with considerable amounts of data being lost and being lost multiple times. I spoke to a lady last week who told me of her data being lost five times. This cannot continue.

With medical cards that were granted recently and are not due to expire for a while, there is no point in reviewing them immediately again, which would be wasting time and delaying the process. Some of these reviews are counterproductive. We are in a demand-led scheme and the applications are complicated. Confusion exists and people need help. They come to Deputies, but we need a better portal to deal with these people.

I welcome this discussion. Health care needs to follow the needs of the patient and the citizens need to feel they are valued and protected especially at vulnerable times when their health is failing.

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