Sandra McLellan (Cork East, Sinn Fein) | Oireachtas source

I agree with previous speakers that the withdrawal of medical cards is probably the issue we have to deal with most on a daily basis in our constituency offices. There is not a Deputy in the House who does not have heartbreaking cases of people being refused discretionary medical cards. We could wallpaper the building twice over with the representations we have made on behalf of our constituents. It is frustrating for us but it is a matter of life and death for many men, women and children we represent.

It is in these very corridors that the real decisions about medical cards are made. It is Government policy that determines whether someone receives the lifeline of a discretionary medical card. My experience as a public representative is best reflected in some of the stories of my constituents but a huge concern to me would be the many people presenting to my constituency office who cannot afford their medications and are not taking any medication at all. A two year old with juvenile idiopathic arthritis needs a drug called methotrexate which comes at a cost of €250 per month but it is not covered by the drugs payment scheme currently. The family applied for the medical card and was refused but that is now under appeal. The family live in fear that if it loses this appeal, it will be forced to pay €3,000 per year required to cover the cost of the drug.

The Government's practice of random reviews of the over 70s is harsh and unnecessary and it has also led to chaos and stress for some of our most vulnerable senior citizens. Notices go to wrong addresses. I had two cases in the past two weeks where the renewals were sent to the wrong addresses and the people's cards were stopped. This is not acceptable. As a result of Government cuts and shortages, these senior citizens lost their medical cards. It is Government policy which is causing this stress and heartache.

Another thing which I cannot understand and which I have come across on at least six occasions in the past few months is where sixty nine and a half year olds are having their medical cards reviewed. By the time the review is done, they turn 70 years of age and they have to go through the process again. This has not just happened once or twice but it seems to be happening quite a lot.

Another case in my home town of Youghal concerns a family of nine whose medical card went to its old address.

Because of the mistake, the family lost their medical card and had to reapply for it. The process is supposed to take 15 working days but it has taken several months and the family has had no cover for the entire period. The confusing part of the situation is that when the card was previously due for renewal, the letter came to the current address and therefore it is difficult to understand how on this occasion the letter went to an address the family lived at years ago.

Further bureaucracy is heaped on those citizens who are having their cases reviewed. The State will not accept evidence during the process of a review. In other words, if a family is refused a medical card and if they choose to have the application reviewed, it must be done within 14 days. Any extra evidence including medical letters, letters from agencies and consultants may well take longer than the two weeks allocated. Those important support letters are then excluded from the review. The very evidence needed for the review is being excluded. Further to that, if there is a change of circumstances in the family when the review is taking place, that too is ignored.

The Government is being given the opportunity to change the situation. It is decision time for the Government in terms of whether it will continue to oversee a chaotic medical card system or if it will step up to the plate and radically reform it. Another issue relates to paperwork constantly going missing. People register paperwork yet it still goes missing. When e-mails are sent a request is made that they are sent again with scanned documents that also go missing.

Sinn Féin calls on the Government to reverse the cuts to discretionary medical cards imposed in the Health Service Executive service plan for 2014. We call on the Government to ensure that people receive the due respect, consideration and compassion they deserve when applying for medical cards. The recent announcement by the Minister for Heath that he intends to introduce universal health insurance is deeply concerning. It is a radical shift in public health policy and it will only serve to make a genuine universal health care system even more difficult to achieve. It puts private insurance companies at the centre of our health care system which is deeply concerning. We call on the Government to set out in legislation entitlement to health care and in line with the recommendation of the Constitutional Convention to provide for an amendment to the Constitution to recognise the right to health care. I urge Government Deputies to support the motion.

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