Michelle Mulherin (Mayo, Fine Gael) | Oireachtas source

Without doubt the issue of medical cards is the single most common one raised at my weekly clinics around the county and that seems to be the experience of other Members throughout the country. A person may be making an application for the first time for a medical card. As a result of the level of unemployment, increasingly more people cannot afford private health care and are being pushed to seek a medical card. The applications I deal with may be for a discretionary medical card for a person who is seriously ill with cancer or some other serious illness, a medical card for a person aged over 70, a review or an appeal and the list goes on. I would like to be very honest and fair about what I say here because this is a very delicate issue. People are vulnerable and are coping with an illness; those are the cases that I believe mostly need to be addressed, as opposed to those related to the basis of means. I am talking about people with serious illnesses or illnesses that seem to fall between two stools. We cannot be throwing oil on a fire - we can try to assist and examine the issue fairly and get solutions, but it is not helpful to incite fear in people, especially considering what they have to deal with.

Along the lines of what Deputy Lyons said, it is important in the national context that this debate allows us to examine what is happening in terms of the figures nationally. The Minister of State has told us that there are no changes in regard to the rules for the issue of discretionary medical cards. We know it is expected, based on figures that have been given, that an additional quarter of a million medical cards will be issued by the end of this year compared the beginning of 2011 when this Government came into office. Some 41 % of the population have medical cards and 49% have medical or GP cards. In terms of the reviews that caused so much fear for people, 96.5% of those with medical cards retained their cards.

With regard to those aged over 70, 93% have access to free GP services and retain that facility and about 80% have retained their medical cards, even in light of recent changes. Those headline figures are reasonable enough but there has been much fear and consternation about this issue in the media. Having had the experience of dealing with people who have had a difficulty or an issue in getting a medical card, I could offer a few reasons as to why they have found that to be the case. The system is not compassionate, reactive or responsible enough to hard cases. I have dealt with many cases and in one case the person concerned, who had a serious illness and really needed a medical card, felt that by the time they got the card the good was almost taken out of it such was the trauma of the process for the family but, nonetheless, that person got their medical card.

People's documents are lost too frequently. That is a basic issue. Documents cannot be found sometimes even when they have been sent by registered post. We are entitled to expect more than that for the people we serve. I have helped people to get a medical card and three months later their cases are being reviewed even though there has been no change in their circumstances. It is no wonder that fuels the idea that we are trying to take people's cards from them. There is something wrong there as well.

I know of a case where a mother had baby with Down's syndrome. The child had complications and on the child leaving hospital the parents applied for a medical card. Nobody advised them of the long-term illness scheme or of the drug repayment scheme. I know the parents concerned, whom I will not name, will not mind my saying this because they have talked about it locally. Their child was due to be taken home from hospital on Christmas Eve and the mother was told that they would have to get certain equipment and they had to buy it using their credit card to bring her child home so that the child would be safe over the Christmas period. Nobody at any point told them of any of the other rights and entitlements they had and I find that unbelievable.

I have spoken to the Minister, Deputy Reilly on this issue on a number of occasions in terms of the cases that have been brought to my attention and having listened to the experiences of colleagues. He has spoken of an integrated care package which would provide care for people who need appliances, medication and so on and these may meet their needs in many cases. An information campaign must be undertaken. I cannot understand why the PCRS cannot advise a person that if they are not entitled to a medical card they could be entitled under the long-term illness scheme or the drug refund scheme.

It does not seem to give out any information like this.

On the budget situation and the term "probity", we know a target was set to bring down spending from €133 million to €23 million. We need to be realistic. More people are applying for medical cards and it is a demand-led service. When the budget is being examined by the Cabinet if we are serious about delivering medical cards to people, the budget must match it.

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