Joe McHugh (Donegal North East, Fine Gael) | Oireachtas source

We are on the cusp of an election and that contribution will go down well in the Deputy's constituency and the local electoral areas. It is important to point out that although the Minister, Deputy Reilly, is not getting the credit for opening hospitals, it is funny that when the shoe is on the other foot, he would get the blame if things went wrong. That is politics and we are all men and women enough to live with that.

I acknowledge the presence of the Minister of State, Deputy White, in Letterkenny General Hospital this week when he opened a new pharmacy unit, and he was also in a position to inspect the ongoing good work on the developments in the aftermath of the worst crisis ever at the hospital last August when it was flooded. The Minister of State would have got a sense of the resilience and proactive nature of the staff, as well as the community's response to an absolute disaster last August. Although the matter has not yet been turned around, the Minister of State would have got a sense that things are going in the right direction. We were glad to have him there to see that first-hand.

We will not get a more emotive issue than medical cards and entitlements for people who are very sick, vulnerable and at their weakest. This can become a political matter and can be played to the advantage of some. Whether in Government or part of the Opposition, we all work in constituency offices with people, and we would all call for means to improve the process. The new system is centralised now, as opposed to the old system where we could contact people in Donegal, for example, when dealing with local people. We must acknowledge that the people working in the new centralised unit in Dublin are working hard and not just treating the process as a 9 a.m. to 5 p.m. job. They are working hands-on and experience the emotion of the issue. It is not a matter of being empathetic for the sake of it but they are going through the work. Perhaps we can get extra resources to the centralised unit. The appeals office in Ballyshannon is similarly staffed by excellent people doing their best, despite appeals piling up. Perhaps we could put extra resources in there as well. I know the Minister for Public Expenditure and Reform, Deputy Howlin, will read the transcripts of this debate and we must keep a sharp focus on the area.

Many of the people who come to my office are at their weakest and it is difficult for them to prove entitlement. This is how anxiety develops so we must consider that process of having to prove an entitlement through bank statements, medical evidence and doctor correspondence. That is hard work when people are at their weakest, and I know the Minister of State is very conscious of that. If we can critically evaluate the process and try to make it easier, people with cancer or severe health conditions will have an easier time. People are in a particular state of mind when they are trying to battle their own health challenges, and that is the difficulty. This is not just about having a medical card to go to a GP at every turn as it is also a financial issue. People may not have enough money to pay for prescriptions at a pharmacy so we must be very conscious of such difficulty.

Some people may miss the financial constraints so we should consider how this happens. Not every couple or single person is in the same position and although there may be a top line in financial considerations, not everybody is in the same boat. We should be creative and constructively critical in ensuring the process is not arduous or putting extra pressure on people at a very low ebb. These people may have had a medical card up to 2016 or 2017 but have had to prove their entitlement again. This contributes to much angst and we should be conscious of that.

There was a system of free medical cards given willy-nilly to those over 70 and it is difficult to take these from people or critically evaluate the position. At the same time the process must take in every individual's personal circumstances, which is also difficult. We must keep the patient to the forefront, especially the most vulnerable. When people are at their weakest we must try to simplify the system to ensure we protect the vulnerable.

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