John Kelly (Labour)

I thank the Minister of State for attending the Chamber to respond to this issue. On 1 July, the HSE will take control of medical cards and centralise them in Finglas, Dublin . By doing so, the HSE is taking away the discretion shown by community welfare officers in regard to certain family situations that arise. The community welfare officer knows the clients and knows where there are gambling difficulties, alcohol addiction or illness in a house. They show discretion in 10% of cases and this means that people are less stressed. I am particularly concerned about cancer patients and those who suffer from MS, along with many other medical problems. The HSE and community welfare officers always showed a level of sympathy and because of this, discretionary medical cards were granted to these people. Once the service is centralised, discretion will go out the door. People will be dealing with faceless bureaucrats who do not know them and who live 200 miles away in some cases. In those cases, many people will be refused medical cards. Over the years, GPs have advised cancer sufferers to get a medical card from the community welfare officer because they were entitled to it. Consultants gave out that information but this may have been because they were fed incorrect information. Cancer patients are treated the same as everyone else for medical card purposes. They must undergo a means test and if they qualify, they receive it. That is why we introduced discretion in these cases. It is cost neutral because of that.

I call on the Minister for Health to grant medical cards to cancer patients who are undergoing treatment until their illness is cured. This will take away the stress for them. As a community welfare officer, the last thing I wanted to do was means test someone who visited me. People did not realise whether they were terminally ill. We have already learned from the takeover of the over-70 medical card by the Primary Care Reimbursement Service, PCRS, in Finglas that many elderly people had problems in processing their applications. They cannot get through to the centre on the telephone and the same thing will happen in this case. When people are telephoning Departments they use their mobile phones. They might start off with €20 credit and when credit is gone and no one has come on the other end of the telephone, that is the end of the issue. This issue must be addressed. The takeover should be deferred until we can get a commitment on discretionary cards. It will be a major issue and will affect every politician. Saying that everything will work out when this begins on 1 July is the same as saying that community welfare officers are being taken over by the Department of Social Protection, that they will be told all about the job when they start and that everything will be fine. We need to address this matter before it gets to that stage.