Medical card crisis ‘back to the start’

A patient group representing children with life-limiting conditions has warned that Ireland is "back to where we were at the very start" of the medical card crisis due to the Government’s expert panel findings.

Jack and Jill Foundation chief executive Jonathan Irwin made the claim after a leaked version of the report said personal finances will continue to be the way medical card eligibility is decided.

The document was given to the Department of Health by the HSE on Tuesday but is not due to be published until after the October 10 by-elections and October 14 budget.

According to the report: nA lack of adequate ways to “measure the burden” of individual conditions means Government promises to compile a list of illnesses guaranteed the help is not possible;

nTo do so risks “inequity” of care based on diagnosis and would not be “ethical” given the “finite resources” in health;

nAnd “financial hardship or means testing” should remain the “main discriminator” in deciding who receives a card.

The report, which is based on a four-month assessment by a 23-strong independent expert panel, has led to concerns Government will fail to act on its post-local election promises to reform the service.

Mr Irwin said the findings mean Ireland is now “back to where we were at the very start” of the crisis.

“What they’ve said is totally unfair on sick children, who are still not seen as individuals in their own right,” said Mr Irwin.

“Their parents are being means tested, they will probably fail, and there is absolutely no reason to it.

“There are certain conditions where you should have to give a medical card, but instead we are being given this minor fiddling with the system. We’re once again back in the quicksand.

“If [Health Minister Leo] Varadkar is going to be the great leader he wants to be, then the time is now. This isn’t going to get better, it isn’t going to go away just because of this report.

“We are going to continue to seeking sick children’s rights to medical cards.”

Warning the plans risk “failing” cancer patients, the Irish Cancer Society’s head of advocacy, Kathleen O’Meara, said: “The finding that it would be ‘neither feasible nor desirable’ to list medical conditions in order of priority is not surprising, but we hope the panel has also recommended a new system based on medical not financial need. It’s important that the report be published as soon as possible and the Government indicates its intentions for reform.”

While Our Children’s Health took a similar stance, the Irish Hospice Foundation welcomed the report’s findings.

The Irish Medical Organisation said the report showed the previous discretionary medical card system was the best approach and only led to issues when it was “starved of funding”.

Independent experts told they should ‘try harder’ to improve system

By Fiachra Ó Cionnaith

Independent senator and cancer expert John Crown has hit out at the Government’s expert medical card independent panel’s claims that it is too hard to resolve the issue, telling them: “Try harder. Work it out.”

Speaking on RTÉ’s Six One news last night, the consultant oncologist spoke out about the recommendation that the current system for awarding cards should not substantially change.

Prof Crown said the reality for cancer patients who lose the support is that they face potential hidden expenses linked to cancer treatment for issues such as regular emergency department visits, dentist care, wigs due to chemotherapy, and specially designed breast prosthesis underwear.

Criticising the independent panel’s decision to not substantially change the current system to take better account of medical need, Prof Crown said it is simply not acceptable that after four months of research no substantial alternative has been put forward.

Prof Crown said that in other countries where he has worked such as the US it is possible to create a system where certain patients are guaranteed additional help based on their condition, impact on their lives — and financial issues.

Meanwhile, Health Minister Leo Varadkar moved to assure 15,000 people who have had their discretionary medical cards restored in recent months that they will not lose the help.

However, it is unclear what will happen to other people applying now.

“Anyone whose discretionary medical card has been re-instated in recent months need not worry,” said Mr Varadkar.

“Their cards will be extended for as long as they need them. In the meantime, I will consider the report and will bring forward proposals to Cabinet to reform the discretionary medical card system so that very sick people are provided for.”

Mr Varadkar added that he will now bring the report to cabinet after considering it “in detail”.

Fianna Fáil health spokesman Billy Kelleher said any changes must ensure the discretionary aspect remains, while Fianna Fáil finance spokesman Michael McGrath said reforms “must not by any means” be about “making savings”.

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