More over-70s likely to keep their medical cards

MORE people over the age of 70 are likely to hold onto their medical cards than was intended in the budget as a result of Government moves over the weekend.

Taoiseach Brian Cowen admitted yesterday that the Government’s controversial decision to abolish automatic entitlement to medical cards would not go ahead in its present form.

During an interview on RTÉ radio, Mr Cowen accepted that the Government’s decision on the over-70s medical card did not have the wider public acceptance it needed.

“I am addressing the concerns and I think that those that have concerns can be assured of that,” he said.

He is still determined, however, that everyone applying for the over-70s medical card will have to be means tested.

On Friday night, Mr Cowen said he wanted to renegotiate fee levels with the Irish Medical Organisation. A spokesperson for the Taoiseach said contacts had been made with IMO officials over the weekend.

General practitioners have warned that patient services would contract if the budget changes in relation to medical cards for the over-70s was pursued.

The Irish College of General Practitioners said many practices would have to cut back their services to patients to deal with the loss of funding. There is also growing concern that general practices will be unable to continue to provide care for patients who are admitted to nursing homes as a result of the changes.

Over the weekend, doctors and politicians were hopeful that the medical organisation could bail out the scheme by making GPs accept lower fees.

But the medical organisation was saying little other than that GPs were considering all matters and would give a “considered response” once the process was complete.

College spokesman Dr Niall Ó Cléirigh said GPs were next in line after the consultants to become involved in negotiations in a new General Medical Service’s contract.

“The more cynical GPs are saying that the over-70s move by the Government was just a shot across the bows to warn them that the negotiations could be very difficult,” he said.

GP deal

* GPs get an annual fee of about €630 for every patient on their over-70s panel who have been entitled to a non-means tested medical card since it was introduced in 2001.

* Former finance minister Charlie McCreevy unveiled the initiative in his budget of December 2000, with the Department of Health and Children only getting a few days notice of the decision that took effect in July 2001.

* Because the initiative was announced without the terms negotiated, the Irish Medical Organisation (IMO) was able to negotiate a capitation grant for the over-70s that is three times greater than for other patients in the medical card scheme.

* The Government believed 39,000 additional people would qualify at a cost of €9m in the first six months. About 63,000 people qualified, however, and the revised cost estimate for 2002, the first full year of operation, was €55m.

* It has cost the Health Service Executive (HSE) €72m this year alone with over 43,000 cards issued since January.

Timeline: How events unfolded

* On Friday night Brian Cowen went on the RTÉ 9 o’clock news in an effort to quell a Fianna Fáil rebellion which had earlier seen Joe Behan TD resign from the party and other backbenchers saying they would not support the move to introduce means testing for medical cards for the over-70s.

The Taoiseach said he would engage in talks with doctors to change the medical card scheme. But he was adamant that automatic entitlement to medical cards for over-70s could not continue.

* On Saturday morning, a backbench TD said the compromise did not go far enough and the medical card plans would have to at least be postponed.

* Also on Saturday, Health Minister Mary Harney went on RTÉ’s Marian Finucane show amid speculation she would resign if the changes to the card scheme proposed in the budget did not go ahead.

She refused to comment on whether or not she would resign, and said: “If the Government is defeated on this budget and the Finance Bill, the confidence and the authority of the Government to continue would be undermined.”

The principle of universality would not continue, she said: “I don’t think somebody like me, when I turn 70, should get an automatic medical card because if I do, it means somebody else who is 68 or 69 in much worse circumstances, cannot get a medical card”.

* Within two hours of her interview, Finance Minister Brian Lenihan did a radio interview in which he declined an invitation to apologise. “I very much regret the hurt that is being caused to older people. We want to address the concerns,” he said. He also said the Government was willing to discuss the issue with doctors’ groups.

* Later on Saturday night, Independent TD, Finian McGrath, said he would withdraw his support unless the plan is withdrawn.

* On Sunday morning, former minister for health and aunt of Mr Lenihan, Mary O’Rourke, said the income threshold levels should be altered.

* Mr Cowen went on RTÉ radio at lunchtime and said the proposals would not go ahead as they currently stand. But he would not back down on the introduction of means testing.

The Taoiseach also hinted the 1% income levy introduced in the budget, will be “looked at” by the Government on Tuesday.

* At 3pm, Fianna Fáil councillors from around the country gathered in Galway to discuss the proposals, which they feel will damage their votes in next year’s local elections.

They are seeking a meeting with Mr Lenihan tomorrow.

* Mr Lenihan appeared on RTÉ’s The Week In Politics last night and made the same hint as Mr Cowen that the 1% income levy might change, saying “the edges of this can be looked at”.

* Mr Cowen was due to fly to China last night but the state visit will be postponed until Tuesday evening. This will give him time to attend the FF parliamentary party and the cabinet meeting.