Medical cards down 30% despite claims of ‘no cull’

The number of discretionary medical cards in the country is 30% less than what it was just three years ago — despite fresh Government insistence there has been no unfair cull on the service.

Figures revealed at the latest Oireachtas health committee meeting show that, since Dec 2010, the number of people benefiting from the State support has fallen from 80,709 to 50,505 — a 30,204 drop.

The particular category of medical card access is made available to people who are above the standard income threshold, but who can seek discretion due to their individual circumstances.

Previous records show that over the past four years the number of people receiving this type of help has fallen consistently.

The 80,709 December 2010 rate fell to 74,281 the following year, reduced again 63,126 by December 2012, hit 59,000 last June and now stands at 50,505.

However, despite the steady and ongoing reductions HSE director general Tony O Brien, and junior minister Alex White, again insisted no one who needs the help is losing it.

“There is no targeting based on medical condition or otherwise. I can categorically say it isn’t happening,” Mr O Brien said after concerns were raised over a large number of children with Down syndrome who have lost their cards in recent months.

He said the system used now is “exactly the same” as that used before the reduction in discretionary medical cards.

However, pointing to the fact the system is now centralised in Dublin, he said in previous years “variations” have occurred between regions, suggesting some areas were not complying the policy the same as others.

Mr White said even if the HSE wanted to cut certain groups from the system it couldn’t because records on a person’s health cannot be held, with the initial assessment based on financial hardship.

However, health committee chair and Fine Gael TD, Jerry Buttimer, said: “It is a fact that many families are having great difficulty” in obtaining and keeping discretionary medical cards despite there being no change to their individual circumstances.

Fianna Fáil health spokesman Billy Kelleher added it is “quite disturbing” so many people have lost the discretionary help in recent years. Contradicting the Government position, he insisted “there has been a change in policy”.

Meanwhile, the HSE is approximately €24m over budget after the first three months of this year.

Mr O’Brien confirmed that the overspend has occurred mainly as a result of acute hospitals, which account for €20.2m of the overrun — half of which is linked to the ongoing use of agency workers.

Following previous comments made by Health Minister Dr James Reilly during last autumn’s budget announcements, the HSE’s director general said this year will be “challenging” for the system.

Dr Reilly said one of the ways to cut costs in the long-term will be the universal health insurance plan which, despite being published on Wednesday, does not yet detail how much it will cost people or the State, and what exact services will be included.

While not providing alternative costs, the minister said the cost of the plan to two-parent families with two children will be “far less” than the €3,000 figure put forward by independent insurance experts.

Emergency failure

A health committee member has revealed an ambulance was sent 65km to bring him to hospital after he suffered a heart attack in January — despite one being just “a quarter of a mile” away.

Sinn Féin health spokes- man, Caoimhghín Ó Caoláin, detailed the situation during a cross-party discussion on the state of Ireland’s ambulance service.

Speaking at the latest Oireachtas health committee, he said the existing emergency service “is not safe, not responsive and not fit for purpose”.

The Cavan-Monaghan TD said he is one of a large number of patients who allege they have been failed by the system: “I had a heart attack in January a quarter of a mile away from an ambulance base, but an ambulance came from 40 miles away [in Virginia, Co Cavan].”

Mr Ó Caoláin said medics at the GP clinic where he sought help were furious over the situation.

The Sinn Féin TD, who Health Minister Dr James Reilly accused of “shroud- waving” on the issue in the Dáil on Tuesday, said other families have not been so lucky, and face the difficulty of thinking they “might have been able to save” a relative if the service was better.

After Dr Reilly raised concern over the individual case, HSE director general Tony O’Brien said the ambulance sector has been the subject of extra funding and staffing in recent years.

The Health Information Quality Authority is currently reviewing the standard of care in the service.