Minister to reform discretionary medical cards

Minister for Health Leo Varadkar has said he will bring forward proposals to the Cabinet to reform the discretionary medical card system.

The Minister said, "Anyone whose discretionary medical card has been re-instated in recent months need not worry. Their cards will be extended for as long as they need them."

Mr Varadkar added that he will consider the unpublished report by Professor Frank Keane and will bring proposals forward so that very sick people are provided for.

Earlier Fianna Fáil spokesperson on health Billy Kelleher called for the discretionary element of the medical card scheme to be retained.

He was speaking after a report by an expert panel, appointed by the Government to examine the issue of medical cards for people with serious illnesses, said it would be "neither feasible nor desirable" to list and prioritise conditions.

The panel was set up by the Health Service Executive following the outcry over the withdrawal of medical cards.

Speaking on RTÉ's Morning Ireland, Mr Kelleher said that while the scheme governing discretionary medical cards needed to be streamlined, the principle should not be lost.

"The principle was that it would target people who most needed healthcare.

"It was compassionate and it would assist people who are vulnerable, who are sick and who had various illnesses," Mr Kelleher said.

"We all knew that this particular report that was commissioned and Professor Frank Keane was involved in, would simply come up with the fact that it would be impossible to outline every illness and disease and situation whereby a medical card should be awarded to a person on illness grounds, and that is why the discretionary element that was always there should have been retained," he added. 

Speaking on the same programme, Jack and Jill Foundation Chief Executive Jonathan Irwin said he was not surprised by the findings and described the situation facing many parents as "inhumane".

He said that all parents of sick children wanted was for those aged under 16 to be recognised in their own right and granted a medical card.

Mr Irwin said that for a parent of a sick child there is nothing worse that failing a means test, because "you have failed your child again".

He said: "It's inhumane what's going on here. That's an expert report. Experts are experts but we've also got, we think, a very brilliant minister (Leo Vardadkar) on our hands and he's got to show leadership.

"He's got to be able to look parents in the face and say your child is at death's door and will have a medical card until the day he or she dies. That has got to happen.

"If it doesn't happen, the parishes of this country are going to be aflame, not just with the Jack and Jill parents, but with the parents of all sick children because it is so humiliating to be put in a position like this by the HSE."

Minister of State with Responsibility for Mental Health Kathleen Lynch has said the discretionary element of allocating medical cards is still in operation.

Speaking on RTÉ's Today with Sean O'Rourke, Ms Lynch said the medical cards issue is a complex one.

She said she has always believed the best option was to "tweak the system we have".

The minister said the Government is working on the 22 recommendations of the expert panel which was appointed following the outcry over the withdrawal of medical cards.

She said there has been a lot of confusion over how medical cards were allocated over the past 12 months. 

"We have 65,000 cards issued on discretionary grounds and 15,000 that were reviewed last year have been reinstated.

"There are 1.9 million people now with medical cards in this country, that's over 40% of the population. It's very hard to make the decisions when it comes to medical cards, in terms of money, condition, family circumstances and the only sensible way around this is to have universality in terms of the health service."

The Irish Hospice Foundation said regardless of diagnosis anyone facing end of life should be given priority for a medical card.

Chief Executive Sharon Foley said: "There are people out there for whom life expectancy is limited but who don't fall into any specific category, especially older people who are becoming increasing frail."

Currently people who are terminally ill and approaching end of life are entitled to a medical card for a six month period without a means test, once the prognosis is certified by a medical practitioner.

However, the IHF said around an estimated one in five patients who get medical cards on this basis live beyond the six month period - and  the renewal process can be upsetting for patients and their families. 

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