Alan Kelly (Tipperary, Labour) | Oireachtas source

I congratulate the Deputy on putting forward the motion. Everyone in the House is quite supportive of recognising the burden that so many families have had to undergo in terms of getting medical cards and the stress that has been caused to them by the process they have had to go through over a number of years. The fundamental underlying question in the motion is whether children with severe life-limiting disabilities or, unfortunately, in some cases terminal illnesses have the right to a medical card. The fundamental and unequivocal answer to that is "Yes".

I want to acknowledge the response of the Minister to the motion, the statement in the programme for Government and the clarification that has been given on extending the entitlement to medical cards for all children in receipt of domiciliary care allowance in the forthcoming budget. I acknowledge that 11,000 or so children will benefit from this initiative and it will certainly ease the minds of many parents and carers across Ireland who struggle to cope with the day-to-day costs of caring for a loved one with a disability.

I ask the Ministers present to clarify their intentions as regards the timeline for legislation. The House will, I presume, automatically pass any legislation. Therefore, there is no reason we not cannot pass it in advance so that we will not have to wait until later this year or early in the new year and payments can kick in as soon as possible once the budget has been passed. Legislation can include a timeline so that it automatically comes into force subsequent to the House passing the budget. That has been done before. The Minister might consider that. It is something that everyone in the House would probably welcome.

A number of issues have been raised. In the limited time available, I want to speak about them. Domiciliary care allowance is a vital resource for disabled children, their carers and their families. It is incredible that people in receipt of the allowance were not automatically entitled to medical cards without first undergoing a full household financial audit by way of the famous means test. I am glad the Minister spoke earlier about visiting a medical card unit. I am, like some other Deputies, a member of the Committee on the Future of Healthcare. It would be a good move for a number of us to visit such a unit, perhaps with a Minister, and discuss some of the issues that all of us in the House across the political spectrum face in terms of the onerous tolls on families engaged in the medical card applications process. In many cases, they have to repeatedly fill out forms. I do not blame the officials who are at dealing with the applications process. They work within the rules. Given the political process, we can pass on information to the medical card unit based on our direct experience and this could help the process.

Medical cards are a necessity for children who have disabilities as they allow parents to access publicly-run health services free of charge. Their value is incredible to those families. I want to acknowledge the Our Children's Health campaign for the fantastic work it has done to highlight the difficulties in the medical card applications process. Everyone has learned a lot from the work it has done and the many horror stories it has highlighted in terms of the issues families face every day.

Greater flexibility must be shown in the provision of medical cards where there is an obvious long-term medical need on the part of the applicant. A strong ethical governance framework should direct all policy in this area. People should never have to live in fear of their medical cards being withdrawn as a result of a change in financial circumstances, particularly because those with disabilities understand that their circumstances will never change. The exclusive focus on financial hardship in the medical card application process is something that has to change. We must begin to move towards a system that takes a more compassionate and humanitarian approach to how we service the needs of those with severe disabilities. We discussed the Keane report, which examined whether eligibility for medical cards could be based on a list of certain conditions. We all know the outcome of that report. However, it is important that we continually assess the outcomes so that we can offer greater compassion and flexibility to ensure that people who need medical cards get them.

The motion also notes the Department of Social Protection's domiciliary care allowance assessment programme is an example of what a new, changed or tweaked medical card eligibility test could be based on. I concur that this process is much improved from the standard medical card application process as it prioritises the needs of disabled children first rather than the financial circumstances of their households.

We must remember that when we are allocating defined resources, in particular to those with disabilities, we are not just dealing with statistics. Rather, we are having a major impact on the lives of people who face significant obstacles which the rest of us would struggle to understand in our day-to-day lives.

We must, therefore, be cognisant, first and foremost, of the needs of people with disabilities and how we can best provide for their additional requirements in a way which treats them as equal participants in society, rather than just faceless applicants in an overly bureaucratic process, which we are all collectively trying to change. The current medical card application system provides insufficient flexibility in particular for the needs of those with severe disabilities who face a financial means test. We in the Labour Party, and Members collectively across the House, would argue that the economic status of a household should never prevent children in need, in particular, from availing of services to which they should be entitled as a right.

It is with all that in mind that the Labour Party will support the motion. We are delighted that everyone in the House supports the motion and that the Government is accepting it. I note what the Minister said earlier but I stress to both Ministers of State who are present that this was a commitment in the programme for Government. We now have a motion that is supported by all parties and all Members in this House. It would be another welcome step in the right direction for the Minister to outline at the conclusion of the debate the timeline for putting the change in place and if it can be done in advance of the budget. That has been done previously with a post date to the budget timeframe so that once the budget is passed by this House - I hope the budget is passed by this House - that the measure will kick in straight away. That would be a very positive endeavour. The House would welcome it very much if the Minister could come back with such news.

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