Minister for Health signals shift in medical card policy

Varadkar says issuing of cards based on ‘hierarchy of illnesses’ may not be realistic

Minister for Health Leo Varadkar. Photograph: Frank Miller

Minister for Health Leo Varadkar. Photograph: Frank Miller


New Minister for Health Leo Varadkar has indicated he may walk away from the Government’s plan to start issuing medical cards on the grounds of medical condition.

In the first clear expression of a change of policy since he became Minister a week ago, Mr Varadkar warned the plan could result in nearly everyone having a medical card and this would not be realistic.

His predecessor, Dr James Reilly, announced the plan to extend eligibility for medical cards to people with specified illnesses shortly after the local elections. The disastrous performance of the Government parties in the elections was widely blamed on the removal by the HSE of medical cards from thousands of seriously ill patients.

Dr Reilly set up an expert panel to advise on which conditions would qualify under the scheme and what level of severity would be required.

However, Mr Varadkar said yesterday it would be very difficult to create “a hierarchy of illnesses” for the purpose of the scheme. Even within illnesses there were degrees of severity and the issue of co-morbidity (multiple illnesses) also arose.


“If you look at the international classification of disease, things like overweight and obesity are considered to be illnesses, too, so you would be potentially extending medical cards to almost the entire population, which would not be realistic.” He said he would allow the expert panel to report back in September before deciding what to do.

Mr Varadkar denied there were any differences with Dr Reilly over the division of responsibilities on public health, and their respective responsibilities were clear.

“James is going to continue with his crusade on tobacco and I’m totally behind him on that. He’s going to continue to have a big role on childhood obesity and we’ll be working jointly on the Healthy Ireland strategy.”

Mr Varadkar admitted the HSE would run up a deficit of €400-€500 million this year, and a supplementary budget was inevitable.

However, cutbacks in hospitals were “not intended” as these would reverse the progress made in recent years. His priority was to work hard with other Ministers to put in place a realistic budget for next year.

Universal primary care

Mr Varadkar said he was committed to universal primary care but this had to be done in a “sensible and logical” way that did not overwhelm general practice. Free GP care for children and over-70s would be brought in during the Government’s term in office.

He said there was lots of good news in the health service, including reductions in the price of medicines and the number of patients on trolleys, as well as a reduction in outpatient waiting times.

Outpatient waiting lists had soared since the start of the year, but Mr Varadkar said he preferred year-on-year comparisons, which show a slight drop from May 2013 to last May.

On alcohol, the Minister said he planned to press ahead with minimum pricing legislation and restrictions to availability. On the introduction of a sugar tax, he said he was not in favour of more taxes and would need to be convinced by international experience.