TERMINALLY ILL cancer patients are now being refused discretionary medical cards by the Health Service Executive, it was claimed yesterday.
Fine Gael health spokesman Dr James Reilly claimed to the Oireachtas health committee that two people he was aware of in Dublin - one in Ballyfermot and one in Walkinstown - had been denied discretionary medical cards even though they are dying of cancer. "To me that is about as bad as we go as a society," he said.
The HSE said later that discretionary medical cards are allocated on a hardship basis. It had made no blanket decision to stop all discretionary medical cards for terminally ill patients. It confirmed the cards are means-tested.
On Budget day it was announced, however, that the amount of money available for spending on discretionary medical cards next year will be reduced.
Meanwhile, the committee heard the National Cancer Screening Service has been allocated the required €1 million for next year to allow it to do groundwork for the introduction of a national bowel cancer screening programme, which is expected to be rolled out in 2010.
Also at yesterday's meeting, Minister for Health Mary Harney confirmed there will shortly be a supplementary estimate of €70 million brought forward for the HSE to cover the cost of the introduction of new consultants' contracts during the second half of this year.
But she warned the HSE would not pay this money to consultants unless they displayed changed work practices.
Under the new contract, consultants are expected to work in teams over a longer day during the week and also be rostered to work at weekends. She said 1,000 consultants had changed over to the new contracts and 300 have taken up contracts which will see them treat public patients only.
HSE chief executive Prof Brendan Drumm agreed it would be "a huge challenge" to ensure those who stayed on the old contracts did not spend more than 20 per cent of their time seeing private patients. "It may be difficult."
Prof Drumm also said in future the HSE could not continue to invest in hospital services if it wanted to spend more on improving community services. The indication for next year is that acute hospital beds will close to finance more spending on community services.
"2009 will be a financially demanding year. Maintaining 2008 service levels will be a real challenge for us," he said.
"We will have to maximise our efficiency, streamline how we do things, trim costs, cut out duplication, reduce the over-reliance on high-cost acute hospitals and provide more integrated community- based care," he added.
Prof Drumm pointed out that the HSE has so far this year delivered care above and beyond targets in its service plan, and would still come in within budget at the end of the year. He said outpatient attendances, for example, were 18 per cent ahead of target.
The meeting was also told there is an expectation that the cost of capital projects such as the new national children's hospital may come down by 20 to 30 per cent in the current economic climate.