Of all the banana skins that tripped the Government parties up in this month’s election, the medical card issue was perhaps the most unlikely.
The controversy over eligibility for the cards had been rumbling on quietly for over a year. There were sporadic reports highlighting hard cases where patients lost a card, or were refused one.
The HSE countered that nothing had changed in its assessment procedures, save a move to centralised processing and greater uniformity in decision-making.
The argument seemed to be going nowhere until circumstances changed. First, the HSE, under pressure to make even greater savings, increased the number of reviews of medical cards it was carrying out.
Second, GPs, enraged over the Government's plans to introduce free care for under-sixes, went on the offensive, using the medical card issue as a stick to beat Ministers with.
Reports of hardship
With more cards being reviewed and more cards being removed, reports of hardship multiplied. Campaigners such as Jonathan Irwin of the Jack & Jill Foundation repeatedly highlighted the dire consequences for families of losing a card, and the issue finally surfaced on the radar of politicians preparing for the election campaign.
Almost a month ago, dozens of backbench Fine Gael TDs vented their anger on Minister for Health James Reilly at a meeting of the parliamentary party. This prompted a half-hearted about-turn by Ministers, who took to promising action on the issue without spelling out in detail what was to happen.
Issue of concern
None of this washed with voters, 58 per cent of whom told an RTÉ exit poll last Friday that medical cards were an issue of concern. This was a higher figure than for any other issue.
Fine Gael backbencher Mary Mitchell O’Connor acknowledged yesterday the issue had come up at many of the doors she had canvassed. “In many cases it was the worry of it that caused the difficulty. People feel vulnerable, they feel weak, and beaten by the system, and this wasn’t helping.”
Party colleague Peter Fitzpatrick, like Mitchell O'Connor a member of the Oireachtas health committee, said medical cards ranked after water charges as an issue on the doorsteps.
"People wanted clarity, but there was too much correspondence and a lot of people got confused." He blamed the HSE for trying to carry out too many reviews. Another committee member, Labour TD Robert Dowds, said Ministers were too slow to appreciate the significance of the issue, even though backbenchers were drawing attention to it.
Realising there’s a problem is one thing; solving it is something else. The row over medical cards is a direct consequence of the repeated cuts to the health budget. Indeed, the situation would have been much worse if Dr Reilly and the HSE hadn’t succeeded in cutting the amount of “probity” measures in last year’s budget.
If the Government does decide to loosen the purse-strings for medical cards, it will have to make savings – cuts – elsewhere in the health service.
The results are likely to be equally unpalatable.
