20,000 fewer have discretionary medical cards

The number of discretionary medical cards issued to seriously ill patients, who do not meet eligibility criteria, has fallen drastically in the past three years.

Figures detailed in HSE performance monitoring reports show there are 20,000 fewer patients with discretionary cards than 2010.

It has also emerged that the Government is considering asking disability and mental health patients to contribute to the cost of their care. The Department of Health is examining options, including those above certain income thres-holds or asset base to make a contribution to their care costs.

In Dec 2010, 80,709 people suffering from a range of health conditions, including cancer, availed of a discretionary medical card. That had fallen to 74,281 by Dec 2011 and to 63,126 by Dec 2012. The downward trend has continued this year, with 59,000 at the end of June.

The files do not detail how many people applied for discretionary cards in the years in question or if the fall-off is because there are fewer patients or a higher volume of rejections.

Discretionary medical cards are given to people who fall outside of the standard medical card financial criteria but are still considered to be in need of state-funded help. This is decided when their GP or consultant writes a letter requesting the discretionary document on their behalf.

Applications are then assessed on a case-by-case basis by a panel of doctors. In the case of terminal patients a decision can be made within 24 hours.

Senior health service officials became embroiled in controversy last week after telling the Oireachtas health committee only terminal cancer patients are automatically guaranteed support.

Independent senator and consultant oncologist Prof John Crown described the situation as “horrifically unfair” on cancer patients whose condition is not terminal but who are still in need of financial support.