John Kelly (Labour)

I would like the Minister for Health to come before the House to address a number of issues relevant to his portfolio. One such issue about which I am extremely concerned is the proposed centralisation of the medical card system. The system under which those over 70 years were dealt with by local community welfare officers in their counties was centralised to Dublin. It is proposed that from next month the entire system for medical cards will be centralised to the capital. The decisions in this regard were made in the past by the HSE and I am of the view that they will give rise to no material gain to those who use the service, namely, those who have or are seeking medical cards. Instead of applying to their local community welfare officer, people will now be obliged to deal by telephone with faceless bureaucrats in Dublin who will not understand the family circumstances of those with whom they will be dealing from a social and economic point of view. Owing to the fact that local community welfare officers are aware of families' circumstances, they are in a position to exercise a certain amount of discretion in particular cases. Under the new system, this will no longer be the case. One of my major concerns relates to the fact that a great deal of discretion was exercised in the case of those suffering from cancer. I estimate that medical cards were given to cancer patients 100% of the time. This was despite the fact that they may have exceeded the thresholds laid down in the guidelines relating to medical cards. It is a pity Senator John Crown is not present because consultants and GPs-----