Health Minister accused of delaying providing medical cards for terminally ill

Campaigner challenges Stephen Donnelly's claim that legislation is needed to ensure terminally ill patients have access to medical cards for two years

Health Minister Stephen Donnelly has claimed new legislation is needed to ensure the terminally ill had access to medical cards for two years. Picture: Sam Boal/Rollingnews.ie

The Minister for Health has been accused of delaying providing medical cards for terminally-ill patients.

Stephen Donnelly told OceanFM on Friday morning that new legislation would be needed to ensure the terminally ill had access to medical cards for two years, which one campaigner suggests is incorrect.

"The report said you need primary legislation to do it and it's complex," Mr Donnelly said.

"I tasked the department with exactly how we do that, so I'll be expecting that report soon.

We fully intend on moving on this, but the report I inherited basically said, in order to do this you've got to do it with legislation so we just want to make sure that we get it right."

Currently, only those with a 12-month prognosis qualify for an 'end of life' medical card, which is not reviewed or means-tested.

The HSE Clinical Advisory Group submitted its report to the Department of Health in September 2020.

"Given that End of Life is associated with significant needs and that not having a medical card could cause undue hardship, granting eligibility on End of Life grounds may be clearly seen to fall within the existing legislative framework," the report states.

"The Clinical Advisory Group also arrived at a view that legislative change would most likely be necessary to underpin such a change. The Clinical Advisory Group therefore sought to define or provide clinical criteria / supporting criteria that might enable legislative change to underpin medical card eligibility based on prognosis other than the current discretionary End of Life."

John Wall, a campaigner who has prostate cancer, has been campaigning on behalf of other terminally ill patients for more than 18 months.

"Legislation is not required for policy changes, the report found it would be beneficial to underpin the changes with legislation, but in the here and now, the Health Act makes no reference to 12 months in reference to medical cards, that's a policy decision."

Mr Wall said people who fall outside the 12-month bracket have difficulties accessing a card.

Those who do manage to qualify are subject to a review every six months, as well as a means test.

Mr Wall would like to see an end to this practice, as well as the terminal prognosis threshold increased to 24 months.

"I didn't endorse Mr Donnelly's plan back in November, as I wanted to see tangible implementation to those who need it most on the ground," Mr Wall added.

"I know the long-term change won't happen overnight, but in the short term, something immediate and actionable is necessary.

"[The legislation] is a delaying tactic, this issue has been in programmes for government for years, it was in the budget expenditure report last year, and seems to be omitted from this year's budget.

"I want to put this to bed, I want to move on, I don't want to spend the next year of my life on this. I should be concentrating on my family, there's a lot more important things in my life, considering my diagnosis, in saying that, I'm not letting go of this, I won't let it go.

"I've come across terminal patients with issues who can't access the process.

You'd think the Government could say: 'I'm sorry you have an incurable disease and dying, here is a small thing we can do for you'.

"It won't cost an extraordinary amount of money.

"I just want the minister to engage meaningfully with something in his own programme for government, he got elected based on his own electoral promises, of which this was one."

A spokesman for the Minister of Health said: “The Minister for Health and the government want to extend eligibility for medical cards to people with terminal illnesses for prognosis timelines exceeding those encompassed by the existing End of Life discretionary criteria.

“Following engagement with the Minister, officials in the Department of Health set out a work programme to seek to give effect to the Programme for Government commitment on medical cards for those with a terminal illness, taking account of the findings of the CAG, including the need for a legislative approach, and the challenges it identified including in relation to prognostication and definition.”