Analysis: Motivation behind medical card campaign is clearly political

Cash-strapped HSE is spending money to tell public it has misunderstood its position

The information campaign on medical card eligibility announced by the HSE yesterday is unlikely to make much difference to those most directly affected.

As Minister for Health James Reilly and his officials are fond of repeating, nothing has changed. The guidelines on income and the application of discretion are the same, along with the insistence that there is "no automatic entitlement" to a card.

What the public may notice is that their letter of refusal is written in plainer English. When they query a decision, they will be able to ring the helpline later in the evening. Staff will be better trained and more sensitive, but their message won’t change.

The motivation behind the campaign is clearly political; for weeks now, hard-luck stories of people who were refused cards have dominated print columns and the airwaves, further sapping public support for the HSE and a beleaguered Minister.

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There is something odd about the HSE, which is starved of resources and preparing to cut hundreds of millions of euro off next year’s budget, spending money to tell the public it has misunderstand the position in relation to medical cards.

Where individual decisions have been reversed, it appears from yesterday’s briefing by officials, this was generally because people failed to provide necessary information in their original application.

Whatever the Minister and his officials say, the numbers seem to tell another story. Reilly insists there is no slowing down in the issuing of cards, yet the number of cards issued so far this year has increased by only 2,444, compared to more than 160,000 last year. New cards are being issued, but older ones seemed to be disappearing at a similar rate.

The Minister and officials argue that there was a spike in approvals last year to clear a backlog of applications. There is some truth in this but it is hard to see how it explains the entire gap.

A slew of GPs, along with consultants such as Orla Hardiman, have highlighted the difficulties experienced by their patients in obtaining a medical card. Are they wrong, misinformed or blinded by sympathy for their patients? The HSE's response is to say again that there is no automatic entitlement to a card based on illness.

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times