HSE asked to explain denial of medical cards

Health bosses are being asked to explain whether there is a deliberate policy to deny people their right to appeal decisions to withdraw or refuse discretionary medical cards.

The chairman of the Dáil’s Public Accounts Committee, John McGuinness, said a “basic principle” that has historically applied to all areas of public service is now being removed by stealth.

He said letters are going out to seriously ill people who have lost their medical cards, saying the decision will only be reviewed if they have additional, new information relating to their condition or financial circumstances.

“They are phrasing it in such a way that people are being told they do not have the right of review, unless they have significantly different information,” said Mr McGuinness.

“They are basically being told that their doctors have to write up new reports on their cases. And if you already have a letter saying you are at death’s door, then what else could you get to say you are worse than that?”

The Fianna Fáil TD said he was not happy with the response given to him on the issue when he raised it at a PAC meeting to discuss the medical card scheme last Thursday.

John Hennessy, head of Primary Care at the HSE, said he was “somewhat baffled” by Mr McGuinness’s comments, because the right to seek a review has not changed.

However Mr McGuinness believes the HSE is being clever with the wording of its letters, so as not to explicitly deny a review, but to give people an impression that they are not entitled to appeal.

He is giving health bosses 10 days to provide written responses to a range of questions on medical cards put to them by the PAC which they were unable to answer, and said if they fail to do so they will be called before the committee again.

The HSE officials, who included Mr Hennessy along with Paddy Burke, who is in charge of the medical card scheme, and chief executive Tony O’Brien, were asked by TDs: How many of the 6,324 people who had lost their discretionary medical cards so far this year were children with Down’s syndrome; how many or what percentage of medical cards were refused; how many were appealed; and what was the waiting time for appeal decisions?

These were among the number of issues that TDs said they did not get satisfactory responses to from the HSE, who recently launched a €150,000 communications campaign to provide clarity on the medical card fiasco.

“I wasn’t satisfied with the HSE at all,” Mr McGuinness said about the meeting. “In too many instances when questions were asked of them, they didn’t know, they just didn’t know the basic analysis of the issue and they now have to come back to us with a huge amount of information,” he said.

“We will pursue them for the answers. Members of the PAC have decided we would give them 10 days to come up with answers, and if a substantial effort wasn’t made, we would send for them and bring them in again.”

He has also asked the Department of Health to answer parliamentary questions from TDs instead of referring them to the HSE. This has been a constant source of frustration for TDs who face delays in getting basic information, and it means that the responses are not publicly available on the Dáil record, as they are for questions to all other departments.

“You have to wait a long time before you get some answers, particularly to urgent questions,” Mr McGuinness said. “I’m asking, as with any other parliamentary questions, that they are answered within three of four days,”

But the secretary general of the department, Ambrose McLoughlinn, said: “We will deal with them in an appropriate way. If the answers are appropriate to the separtment and its minister, then of course they will be dealt with expeditiously. But if they are service issues that deal with service matters, of course we will have to engage with the HSE.”


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