Martin Browne (Tipperary, Sinn Fein) | Oireachtas source

So be it, but the Minister for Health has a habit of not appearing in the Chamber for Topical Issues, and this has been raised before.

I have asked for this matter to be discussed because it is reflective of the difficulties that can be experienced by people with life-long conditions and their families. The constituent of whom I am speaking is a 17-year-old girl. When she was born she was diagnosed with Treacher Collins syndrome, cerebral palsy and chromosomal abnormalities. She requires access to a variety of medical materials which are sourced through the HSE medical card scheme, and several elements need to be renewed on a regular basis. These include a suction machine, a portable nebuliser and a tracheal dilator. The list is extensive. I am only providing an outline. This young lady needs access to the general medical card.

Natalia has had a medical card since birth, which has given her access to a range of operations, procedures, appointments and medical interventions, both here and in France. It has also given her access to vital medical supplies. The family says the care they have received at all levels has been superb and they want to stress that. The issue they have is with a letter they received from the national medical card unit in January 2024, which set the scene for months of over and back within the medical card unit. They will be the first to admit that they had assumed that, given Natalia’s complex diagnosis and her situation, her medical card would automatically be renewed on a discretionary basis. They have described the process that followed as nothing less than tortuous. They had to submit 80 pages of documentation. They had to make an inordinate number of phone calls and ultimately had to devote a substantial amount of time and energy to reconfirm Natalia’s conditions, which, I must reiterate, are lifelong.

I should note that while they have been devoting all this time and energy to the review, Natalia’s parents have continued to look after her complex psychological and emotional needs. In all, they have questioned the process they have been subjected to and they have done this against the background of the concept of care and how it reflects on the State’s approach to care for people with disabilities and long-term conditions in the area of medical card provision. Their suggestions are constructive. I ask the Minister of State to accept their suggestion that life-long medical cards be considered in instances where life-long conditions, such as those I have described, are registered with the Department.

I also ask that a second suggestion be borne in mind. When people have disabilities that are not lifelong, the national medical card unit could issue a more concise document to alleviate the disruption that the reviews in their current form impose. I acknowledge that the Department cited the considerations of its 2014 expert panel on medical card eligibility. It stated that to list medical conditions in priority order for medical card eligibility was not justifiable. It added that a person’s means remained the main qualifier for a medical card and that discretionary medical cards can also be issued. The Department also referenced its pledge to keep medical card issues under constant review to ensure the medical card system is responsive and sensitive to people’s needs.

Given the complex and ongoing nature of the conditions certain people have and the demands they will always have for access to treatment and aids, surely there is an onus on the Department to resolve the complexity and arduous nature of the process that people have to endure. Those who have conditions that are complex and affect every part of their lives should be given a commitment that their needs will be provided for without the painful process that the reviews in their current form involve.

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