2 Jun 2014

Dublin: HSE Could Restore Lost Medical Cards: IMO: *UPDATED


*A senior Government source has said that all issues around discretionary medical cards are being examined, including the possibility of returning discretionary cards already removed as part of the review process.
The Health Service Executive had indicated that it would not be immediately possible to restore the thousands of cards taken away before the review was suspended.
It said that people who have been refused medical cards will not have the decision overturned following the suspension of the review because it is not legally possible.
The Government has faced mounting criticism for the review process, with it being blamed for both Labour and Fine Gael's poor performances in the Local and European Elections.
Minister for Transport Leo Varadkar has said over the next one or two weeks the cases of those who have lost their cards will be considered.
He also confirmed that the issue was discussed at yesterday's Cabinet meeting.
Minister for Communications Pat Rabbitte said medical card provision has always been based on an assessment of means, not particular illnesses.
He said there has always been a discretionary capacity and there has been an explosion in the number of cards available.
What happens next is up to Minister for Health James Reilly, he added.
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*The minister for Finance has confirmed that some people who lost their discretionary medical cards during recent HSE reviews will have them returned.
Speaking at a press conference this morning, Michael Noonan said there was a “long discussion on medical cards at Cabinet yesterday”.
“The Minister for Health is bringing back detailed proposals. And one of them will deal with the return of medical cards for some of those people who lost them,” he added.
Earlier, Leo Varadkar had said that the HSE would examine whether the cards should be restored on medical grounds – rather than by means testing.
“Over the next week or two, the HSE is going to examine options as to how cards might be restored on medical grounds – or issued in future on medical grounds. Because at the moment, in the law, people only get medical cards on the basis of low income and not on the basis of medical need,” he explained to reporters.
The discussion at Cabinet included the unresolved issue of people who have already had their cards taken off them under the HSE review process that was ongoing for some 18 months before it was halted entirely by the government last week.
From January 2013 to April 2014 there was a fall-off of 16,000 discretionary medical cards. During the same time period, there were 22 per cent fewer people considered eligible for the cards.
As of 1 April this year, there were 1,779,103 medical cards of which 49,596 are discretionary
Keywords: medical cards
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Medical cards could easily be restored to the thousands who had already lost them before the review process was halted last week, according to the chairman of the GP Committee of the Irish Medical Organisation.
Dr Ray Walley contradicted suggestions by the HSE that it would not be logistically possible to immediately restore thousands of discretionary cards which were taken away from children with Down Syndrome and people with serious illnesses or disabilities through a review process that has been taking place over the past two years.
He said family doctors, through a computer system, could reinstate eligibility on an emergency basis in what would be a “very quick” process and policy makers could then sit down to figure out who should get cards based on their medical conditions.
“Care needs to be provided on the basis of medical needs,” he said. “There is no evidence-based medicine out there that indicates that 240,00 under sixes are being disenfranchised.”
He said the €37 million being collected through a tax levy on prescriptions should be used to provide the cover for discretionary cards.
Communications Minister Pat Rabbitte said the latest medical card probity exercise was a “Government decision” at the time of the last budget “in order to protect education and in particular social welfare”.
Defending the role of the Junior Minister with responsibility for the system, Alex White, who is also contesting the Labour Party leadership, Mr Rabbitte said: “It was a Government decision, €113m was finally agreed in the negotiations, through probity measures. Nobody was very clear at the time what exactly they were. “To say that the Junior Minister in the Department is responsible; he’s responsible for doing what he’s told by the Government. It was a cabinet decision.”
He also said there was “quite a lot of people who didn’t bother engaging to reply” with the review process — based on figures showing around 10,000 people lost their cards last years as a result of not producing the correct documentation or not producing any at all when asked to by the HSE.
“It is very fair to criticise the Government for taking so long to respond to a number of cases in which nobody could defend the card being taken away, and the manor and tenor of the correspondence that they got,” he said.
“But is it unreasonable — given the straits that we are in — that the situation ought to be examined,” he asked. “The manner of its doing is another issue, but is it not reasonable when there was quite a lot of people who didn’t even bother engaging to reply.”
When it was put to him that many did not provide the necessary material because they were incapable due to ill health, learning disabilities or dementia, he said: “That may be so, but you can’t say either that a lot of them who didn’t reply were not entitled to have a card.”

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