Ryan refused medical card for a fourth time

The devastated mother of a toddler with Down syndrome whose application for a medical card has been refused for a fourth time said she believes the HSE has washed its hands of her son because he will cost them too much in the long term.

Nichola Gilmartin, the mother of 16-month-old Ryan Gilmartin, discovered the application had again been rejected during the return trip to their Mayo home on Thursday, after she had travelled with him to Leinster House to hand in a petition calling for reform of the medical card system to be fast-tracked.

“I’m just so deflated, so annoyed and frustrated,” she said. “It’s like banging your head off a brick wall. I think they think Ryan is going to cost them too much money in the long term.”

The rejection comes despite several interventions on the Gilmartins’ behalf by Taoiseach Enda Kenny, who emailed Ms Gilmartin last November saying: “I trust that the matter will be resolved to your satisfaction as soon as possible.”

Ms Gilmartin received an email from the HSE on the return to Ballina on Thursday evening saying their status in relation to the application had been updated. When she made further inquires, she was told the family had been issued four GP visit cards — one for each member of the family.

“I said we’d never applied for GP visit cards,” she said. “What we wanted was a medical card for Ryan.”

She said the HSE told her she could appeal the decision within 21 days of receiving a formal letter of offer of the GP cards, which would be made in the next 10 working days.

Ryan has a host of other conditions including a hole in his heart, recurring pneumonia, febrile convulsions, and reflux. He has been hospitalised eight times since birth. Ms Gilmartin has cut her working week to one day to care for him and said the family has spent almost €5,000 on Ryan’s care since he was born.

They do not have private health insurance. Ms Gilmartin said a medical card would help cover the cost of the “broad range of services” Ryan requires.

It is possible their application will be deemed eligible on appeal providing their finances meet the criteria for qualification, but Ms Gilmartin said that could take “another six months”.

Kevin Shortall, spokesman for the lobby group Our Children’s Health, said the Primary Care Reimbursement Service, which awards cards “unfortunately had to ignore important parts of [the Gilmartins’ application] because of the manner in which the system operates”.

“It’s incapable of looking at medical needs and it heaps more pressure and worry on families. The system is a big financial audit that doesn’t take the person into account at all.”

A HSE group is examining how to reform the system to make more discretionary supports available. A spokesman for the Department of Health said the discretionary medical card system “is in the process of being revised” and that “in many cases medical devices and other supports are being provided directly to patients, as requested by parents and campaign groups”.

“However, ultimately as long as a two-tier health system is in place, there will unfortunately always be marginal cases,” the spokesman said.