Medical card regime based on conditions delayed until 2015

Government plans to issue medical cards on the basis of medical conditions will not now take effect until legislation is passed next year, according to Minister for Health James Reilly.

Dr Reilly warned that while an expert group charged with advising on which medical conditions will qualify for a card was expected to report in the autumn, the necessary legislation “may take some time”.

He was speaking at the announcement yesterday that discretionary medical cards are being returned to 15,300 people from whom they were removed in a controversial review process over the past three years.

However, people who apply now for a discretionary card will continue to be assessed under the existing means-based system until the new process taking account of medical conditions is enacted, probably by the middle of next year.

The Government’s U-turn, which went further than expected, was welcomed by patient groups and the Opposition, though questions were asked about the rules that will apply to new applications until the system is changed.

Jonathan Irwin, chief executive of the Jack & Jill Foundation, said:"What about the new cases being referred to us? Children with life-limiting or life-threatening conditions, some of them palliative. Will their passage to their medical card be smoother?"

Expense refunds

Fianna Fáil said people whose cards were being returned had a "strong case" for a refund of medical expenses. However, Dr Reilly ruled this out, saying the decision made in each case was validly and legally arrived at.

The decision made at Cabinet yesterday covers cards removed between July 1st, 2011 and May 31st, 2014. The cost of the measure is €13 million a year. Dr Reilly said he had received “categorical assurances” from fellow Ministers that this was “new money” from outside the health service.

The funding is expected to be provided to health by way of a supplementary budget later this year. Meanwhile, the €37 million allocated to fund free GP care for under-sixes is unlikely to be spent this year.

The Irish Medical Organisation, while welcoming the decision, said it undermined arguments for extending GP cards to under-sixes.

Yesterday’s decision will allow for the return of cards to people with an acute medical condition or a lifelong condition, including disability. According to the Health Service Executive, 7,118 people who had their cards downgraded will move from a GP visit card back to a medical card; 5,288 who lost full medical cards completely will have them restored; and 2,899 will have GP visit cards restored.

‘Unintended consequence’

Apologising to people with serious illnesses who lost their cards, Dr Reilly said what happened was the “unintended consequence” of the decision to centralise the processing of the cards in 2011. The number of discretionary medical cards has fallen by about 30,000 over the period, but the HSE says the 15,000 cards not covered by yesterday’s decision include people who have died and others whose reviews were not completed.

Dr Reilly said there wasn’t “a whole lot of room” for more cuts and what was needed was time for more reforms that would produce savings. He said some of the savings suggested for his department would have “catastrophic” and “politically unacceptable” consequences if implemented. “This is a matter remaining between us and other departments,” he said. As for his own political future, Dr Reilly said this was “in the gift of the Taoiseach. He has to do what he feels is the right thing.”

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