‘Fairer’ medical cards system unveiled

Family doctors will be able to restore medical cards to patients for up to a year in rare cases if they believe the vital help has been wrongly withdrawn by the HSE.

The veto was announced by Health Minister Leo Varadkar yesterday, as part of a range of measures which the Government hopes will bring to an end the year- long scandal that damaged the Coalition parties in May’s local elections.

While financial rules will continue to be the central factor in any decision on whether someone should receive a card, a new interpretation of the “burden of illness” rule will be used to allow non-financial health issues linked to the condition to be included.

Mr Varadkar has claimed the changes will lead to a “fairer and more humane” service.

However, the Irish Cancer Society has insisted the changes leave patients “no clearer” now than at the start of the crisis.

Under the measures, based on the views of a 23-strong expert panel:

-GPs will be able to veto the removal of medical cards by restoring them for four months and for up to a year when the removals relate to the most serious cases, as part of a “sensitive renewals” system;

-Terminally-ill people will not have to undergo reviews to retain the support;

-Greater input will be allowed from local health offices in any application decision, although the final verdict will still be made by a centralised service;

-Some 15,000 people who had their discretionary cards temporarily restored after reviews were frozen last May are guaranteed them until a new system is place;

-A clinical advisory group, which will include patient representatives, will be set up to help the HSE decide on whether people with “significant medical conditions” who fall outside the medical card financial rules should receive supports.

The plans are expected to be fully operational by next summer, because new laws may be needed to change the interpretation of “burden of illness” in the existing 1970 Health Act.

Until now, the rule has been focused specifically on financial issues, with anyone above the income threshold rejected except in the most serious cases.

Mr Varadkar said he now wants to “re-interpret” this rule to include non-financial health burdens linked to conditions.

However, accepting such an approach is “pushing [the current law] to the boundaries”, meaning new legislation may be needed.

Patient groups including the Jack and Jill Foundation, the Disability Federation of Ireland, and Our Children’s Health gave a cautious welcome to the plans.

However, they raised concerns that the new system has yet to be costed. The Irish Cancer Society said the changes fall short of what is needed.

In June, the Government was forced to apologise to thousands of people who had discretionary medical cards removed, saying it was an “unintended consequence” of a centralised application office.

The Taoiseach, who had consistently denied there was a policy to remove cards despite cases being highlighted in newspapers and in the Dáil, eventually conceded it “got out of hand” after 1,000 people were losing the support every month.