‘Children will die’ before law is changed

Seriously ill children who have already lost their discretionary medical cards will die before the law is changed to help them, a leading charity has claimed.

The Jack and Jill Foundation issued the warning after it emerged the Government’s suspension of discretionary medical card reviews will not include people who have lost the support.

Speaking in separate forums yesterday, junior minister for primary care, Alex White, and the HSE’s National Director of Primary Care, John Hennessy, both said plans for an expert group to examine the crisis will be confined to people whose cards are “currently” being reviewed.

As a result, they said people who have already lost the help will be unable to alter that decision until a potential change to the 1970 Health Act to provide discretionary cards based on health instead of financial needs is made. This is likely to take until early next year.

During a meeting with the Our Children’s Health group yesterday evening, Mr White clarified that a “protocol” will be “urgently” set up allowing for these individuals to receive the “full range” of required services while the issue is resolved.

He added that a HSE “go to person” will be designated to look after these individuals. However, it is understood the protocol mainly relates to existing services such as the GP card and the long-term illness scheme, which patients have previously said falls short of what is needed.

Despite welcoming the suspension of existing reviews, Jack and Jill chief executive Jonathan Irwin said nothing has changed for children who have lost the help.

“This battle is far from over and Minister White’s statement doesn’t go far enough,” the campaigner, whose group supports seriously ill children with life-limiting conditions, warned.

“What about the children with life-threatening conditions who have lost their medical card?

“The reality is children denied their medical card may pass away while waiting for this system to change. They need a fast pass to their card and they need it now. Many parents are breathing a sigh of relief today. But others are still in limbo, and are too scared or exhausted to speak up,” he added.

The criticism came as Mr White said he “hopes” it will not take years for people who have lost the help to see it restored, and appeared to blame Cabinet — which does not include junior ministers — for the existing problem.

Card claims

The Government minister responsible for solving the medical card crisis has appeared to blame the Cabinet — of which he is not a member — for the scandal.

Junior minister for primary care, Alex White, made the claim while launching his Labour leadership bid.

Mr White admitted the Government has been “too slow” in tackling the problem, and said “I don’t think any of us ever thought” plans to cut €133m from the system — later reduced to €113m and ultimately €23m — were “realistic”.

After saying he will help solve the problem, the TD — who has held the junior minister role since September 2012 — suggested the year-long crisis in his own section was caused by “Cabinet decisions made at the time of the budget”.

Question: Alex White has set up a discretionary medical cards review group? I thought he said they don’t exist?

A: Yes he did, but election whiplash has a funny way of changing opinions. On Thursday, junior minister for primary care and Labour leadership candidate Alex White told the Dáil all discretionary medical card reviews have been suspended, pending an expert group review of the issue. This means those undergoing discretionary medical card reviews will keep it until after the group’s work. The group may also change rules so a card is given to people with certain conditions, instead of on financial need. This may result in changes to the 1970 Health Act.

It should be noted, however, since the Irish Examiner broke the story last July Mr White has insisted there is “no such entity” as a discretionary medical card as it is simply another way of accessing the general system.

As 1,000 people lost the discretionary help a month last year, it was some claim — and one only recently changed.

Q: I’ve lost my discretionary medical card already, What will happen to me?

A: At the moment, nothing. The suspension of discretionary medical card reviews does not change the situation for thousands of families who have lost the support.

Mr White and the HSE’s national director for primary care, John Hennessy, said this is because they already have a decision, and it is not possible to alter that situation before the law is changed.

Until then, a protocol will be set up to give people what they need. However, this relates to GP cards and the long-term illness scheme.

Q: What about general medical cards?

A: The Government’s high-profile moves will only affect people who are currently undergoing a review of their discretionary medical card entitlement, meaning “probity” measures affecting general medical cards will continue unabated.

Q: Tell me about this expert group:

A: We wish we could, but details are thin on the ground — even for HSE officials setting it up. The Irish Examiner asked the HSE to clarify when the expert group will be set up, who will be on it, and what timeframe it has.

The HSE response? “Shortly”. “Work is already under way to identify suitable candidates.” And, our personal favourite, while “it is not envisaged to be a lengthy process, neither is it intended to rush the work”.

Mr Hennessy was equally clear on RTÉ Radio’s Morning Ireland, saying “details need to be worked out”. The best guess is to expect a report within months, but if you have a ruler, now is a good time to measure a nearby piece of string.

Q: Oh. Do we know what specialities the group’s members will be from? Will they include patients, or be confined to HSE officials?

A: Again, no one seems to know. Mr Hennessy said it will include clinical specialists and GPs, while there will be “close liaison” — this does not mean a place on the group — with patients.

When pressed, he said some people were contacted on Thursday, suggesting work on the group did not begin until Mr White announced it in the Dáil, which may explain the lack of detail.

Q: How will the Government pay for the U-turn?

A: That’s a good question. We asked the Department of Health and the HSE. The department passed it to the HSE, which, again, didn’t answer.

Given its never-ending budgetary woes, this will be worth keeping an eye on. The HSE was initially told to cut €133m from the medical card scheme, which later fell to €113m and ultimately to €23m — of which an unknown amount related to discretionary cards.