Lenihan told of medical card 'risks'

MINISTER FOR Finance Brian Lenihan and Department of Health officials were warned that there were "significant risks" attached to the move to abolish the automatic entitlement to a medical card for over-70s in the days prior to the Budget.

Records released yesterday through the Freedom of Information Act show that senior officials in the Department of Finance warned Mr Lenihan and counterparts in the Department of Health of numerous concerns over the move prior to last month's Budget.

In a memo to Mr Lenihan from a senior finance official John O'Connell four days before the Budget on October 10th last, he commented that on the move to abolish the automatic entitlement: "Health appear to either not consider the risks to be of sufficient concern or to be prepared to accept them."

Four days later, Mr Lenihan announced in the Budget the measure to abolish the automatic entitlement to a medical card for over-70s that provoked a political crisis resulting in the Government losing the support of two TDs, Joe Behan and Finian McGrath, and an eventual climbdown after a massive public outcry.

However, the records show that finance officials forwarded a one and a half page report outlining their concerns on the move to Mr Lenihan and Department of Health officials, although the report did not anticipate the political impact or the widespread public anger over the move.

In the memo, finance officials stated in bold that there are "significant risks" inherent in the proposed Government measure.

It stated: "The GPs who will be at a loss of the income from the higher capitation grant may (a) refuse to take on the new over-70 GP-visit-only cardholders because of the lower capitation grant payable (b) they may seek to use their Industrial Relations (IR) muscle or (c) the legal breach of contract route (similar to the pharmacists) to restore all or part of their income. If they succeed, with the annual cash grant in place under the new arrangement, it could remove the projected savings and possibly even increase the cost of the medical card scheme."

Anticipating some opposition from the over-70s, the memo goes further to state: "The new arrangements may not appease the over-70 gold card holder. Those on a GP-visit-only card will have to pay for their drugs up to the new €100 per month Drug Payment Scheme (DPS) threshold."

The memo went on: "If the primary objective of the new over-70s arrangment is to alleviate hardship, this could be achieved with reduced risk by simply raising the income level for over-70s under the scheme to ensure that low and middle income pensioners qualify for a medical card on income grounds."

In response, Fine Gael health spokesman Dr James Reilly said last night that the records confirm the incompetence of the Government and its refusal to take advice.

Dr Reilly said: "It is an extraordinary reflection on the Minister that he wouldn't take the advice from his officials in light of his inexperience.

"It is quite clear that the officials had a reasonable analysis of what was proposed, but it's obvious that neither Minister Lenihan nor Minister Harney did much analysis in this lazy, knee-jerk Budget."