Questions still not answered on lost medical cards

If the room was filled with people who had lost their medical cards — the child with Down’s syndrome, the cancer patient or someone with motor neurone disease — they would not believe what they were hearing.

That was the conclusion of the chairman of the Dáil’s Public Accounts Committee (PAC), John McGuinness, at the end of a five-hour meeting during which 10 men from the health service failed to answer a range of queries from politicians hoping to get to the bottom of the controversy.

Instead, they reamed off legislation enacted from 1970, they repeated a mantra that the law has not changed in the 43 years since, and they repeated their cliches that “fairness, equity, and consistency” is applied in the system.

This was the second time in recent weeks that HSE chief executive Tony O’Brien and his colleagues have been before an Oireachtas committee to discuss medical cards.

But as newspaper pages and TDs’ constituency desks fill with more cases of people losing their cards, the authorities insist there is no change.

The meeting kicked off yesterday with Limerick Fine Gael TD Kieran O’Donnell trying to get very basic figures from the health bosses.

A cross-examination revealed that 6,324 people have lost discretionary medical cards this year following a review of their cases — on top of 2,109 who lost them because they didn’t provide enough information and 6,265 who didn’t respond to a request for information.

But beyond this there is little detail.

Of those 6,324 how many have moved to normal medical cards? The HSE doesn’t know.

How many children with Down’s syndrome have lost their cards? The HSE doesn’t know.

How many refusals have been appealed? The 10-man team of officials with their brief cases of documents, didn’t have the answers.

Sinn Féin’s Mary Lou McDonald raised the real- life case of Katie Connolly, 5, from Douglas in Cork, who this week lost the card she has had since birth.

Asked to explain why this has happened, Dr Ambrose McLoughlin, the secretary general of the Department of Health, said he could not discuss individual cases.

“There is no change in policy. I repeat again: No direction from my department other than to ensure those who need medical cards get them,” he said.

Ms McDonald — who appealed to him to have “the courtesy” of looking at her when he answered, said: “The legislation hasn’t changed, the child hasn’t changed, her family hasn’t changed. The only variable in the scenario is policy. And I am not accepting your assertion to the contrary.”

She then asked how many of the 6,324 who lost their cards were children with Down’s syndrome. More fumbling through notes. No answers.

John Hennessy, the head of primary care in the HSE, said it is nowhere near 6,000. But how did he know?

“We’ve been contacted in the past two to three weeks by a significant number, but it’s not anything near that,” he said.

Ms McDonald said: “Well, a word to the wise, just because you are not contacted, doesn’t mean the experience isn’t out there. We as politicians know that.”

And that summed up what is at the heart of the impasse on this issue: The gap between frontline politicians — who deal with people and cases — and backroom policy makers who deal with rule books and jargon.

But in the midst of the mantra that the policy has not changed was a small but significant admission from Mr O’Brien.

Asked by Fine Gael’s Áine Collins about all the media coverage on discretionary medical cards, he said:

“It is a simple response to the fact that medical cards — whether granted on a discretionary basis or otherwise which were previously held, are, on review, being withdrawn.”

So, the HSE says, people who were getting discretionary medical cards all along who shouldn’t, have been found out and the system is being cleaned up.

This diverges significantly from what Taoiseach Enda Kenny has insisted all along: That there has been no target to reduce numbers, and the reason for people losing discretionary medical cards is that they have moved onto normal medical cards — after theirincomes drop.

So we are still told there is no change in policy, but are now getting a change of explanation.

The cycle of questions without answers continues, the worried public still don’t know what’s going on.


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