Sir, – As the parent of a six-year-old child with cerebral palsy it is with dismay and bewilderment that I read the latest pronouncement from our esteemed Minister for Health, Dr James Reilly (“Reilly plans free GP care for under-fives”, August 6th).
Having announced some time ago that he intended to award medical cards to all those citizens holding a long-term illness card, the department now has confirmed it has abandoned this policy and has decided, instead, to award medical cards to all Irish citizens under the age of five.
The long-term illness card is awarded to citizens who have certain long-term conditions (such as cerebral palsy, cystic fibrosis) and provides for vital medical equipment (eg wheelchairs) and some specific medications but not for the everyday medical needs associated with most disability, and as such it is considerably less useful than a medical card. Medical cards are supposedly assessed on the dual basis of household income and medical need, but in our own experience this assessment is wholly focussed on income with scant regard for medical needs. Thus for households grossing more than €35,000 a year the card is not available even to the most seriously disabled citizens – and this despite numerous representations through the Dáil and the office of the Ombudsman for Children in our specific case.
Now we learn that in addition to all citizens over the age of 70 receiving the medical card regardless of their income or medical needs, all those under five will also receive the card with no assessment of their actual needs or family means. Meanwhile, all those from the age of six to 69, irrespective of their medical needs will, in reality, be denied the card – even if they have already been awarded a long term illness card (which is only possible for those who have been diagnosed with a serious life-long condition).
The latest statement from the department seems to suggest that converting long term illness cards into medical cards would be “too cumbersome” an approach due to undefined potential “legal difficulties”.
So, in addition to a series of savage cuts to the meagre provision for disabled Irish citizens, the one thing this administration had proposed that might have had a real benefit to them has been abandoned in favour of bestowing this benefit indiscriminately upon those under the age of five.
The more cynical among us might think that since that this policy clearly flies in the face of all possible logic, and with impending local and European elections in 2014, this Government has decided to supply medical support to the largest voting groups (young parents and pensioners) in this country rather than those who actually need it. Of course the other possibility is that we are now at the mercy of a Government so incompetent that the best it can do is provide medical cover for countless citizens who do not need it at the expense of hundreds of thousands of those who so clearly do. – Yours, etc,
JONATHAN SHANKEY,
St Mary’s Crescent,
Walkinstown,
Dublin 12.
Sir, – Paul Cullen raises the dilemma of how free GP care for all will be funded (“Reilly plans free GP care for children under-five”, August 6th). Already we see the doctors with their hands out expecting more money.
The solution is for the Minister to start by bringing in salaried GPs from abroad to inner city areas and break the medical monopoly that has resulted in the current outrageously high GP salaries when compared with other European countries. – Yours, etc,
SEÁN BOYLE,
Senior Research Fellow,
LSE Health & Social Care,
London School of
Economics,
Houghton Street, London.