Restoring medical cards
The restoration of discretionary medical cards to over 13,000 people whose general medical services (GMS) eligibility had been cancelled in reviews initiated by the Health Service Executive (HSE) has been widely welcomed. It brings relief to many families throughout the State who had been unnecessarily distressed and had suffered financial loss as a result of what has been termed the “unintended consequence” of the centralisation of the medical card application process.
It has now resulted in a significant U-turn by the Government whereby all eligibility reviews carried out between July 1st 2011 and May 31st 2014 have been set aside. Those affected, who include people downgraded from a full medical card to a doctor-visit-only card as well as those who completely lost either form of entitlement, will have their eligibility reinstated within four weeks, the Taoiseach has promised.
It is regrettable that the policy reversal only came about following a significant electoral setback for the parties in Government. According to post-election opinion polling, some 57 per cent of people who voted in the European and local elections said medical card entitlement was the most important issue influencing how they cast their ballot. The Government U-turn may ultimately reflect a victory for democracy, but a question remains: how was it that so many voices of reason had their concerns about the matter ignored for at least eighteen months?
Politicians have been overly ready to trust the unwieldy behemoth that is HSE bureaucracy. Those in government especially must listen more carefully to the consistent voices of parents with Down syndrome and the partners of those with terminal cancer when it comes to understanding the reality of what is happening at the coalface of health.
It is vital also that Department of Health officials consult widely with those in the caring professions when major changes in health policy are contemplated. The concerns of doctors and others about free GP care for all under-sixes for example, must not be dismissed as driven solely by a motive of professional gain.
The public isalso asking for clarification around the legal opinion used by the Government some months ago to reject calls for medical cards to be issued to people on the basis of illness. Did the Attorney General provide a formal opinion on this matter? And if she did, how is it this legal view can now be cast aside with the promised implementation next year of a policy to provide GMS eligibility on the grounds of specific medical conditions?
While the U-turn on discretionary medical cards is most welcome, as are formal apologies from the Taoiseach and Minister for Health for the distress caused, the Government must urgently address the erosion of public confidence in our health system.