As the Minister of State knows, the primary medical certificate is issued by the HSE and is a declaration to say the holder is severely disabled and-or a permanently disabled person. This certificate is required for the purposes of the Disabled Drivers and Disabled Passengers (Tax Concessions) Regulations 1994. A primary medical certificate is only awarded to people with a very high level of disability. Holders of the certificate automatically qualify for a disabled parking permit. The primary medical certificate also provides a tax relief or fuel rebate for disabled drivers and passengers. Reliefs may also be used to help disabled drivers adapt their vehicles.
Qualification for the primary medical certificate is subject to one of several conditions, for example, being wholly or almost wholly without the use of both legs, or being wholly without the use of one leg and almost wholly without the use of the other leg. The conditions go on like that and it shows us how archaic the system is at this stage, that these are the criteria which are still used regarding qualification.
I am led to believe the HSE is considering the matter of primary medical certificate assessments in the context of its revision of the HSE recovery and restoration plan. In reply to a recent parliamentary question, the Minister for Finance stated:
Following approval of the Finance Act 2020, which provides for the medical criteria for the Disabled Drivers Scheme in primary legislation, a comprehensive review of the scheme, to include a broader review of mobility supports for persons with disabilities and the criteria for qualification for the Scheme, will be conducted this year. On foot of that review new proposals will be brought forward for consideration.
I have many examples of people who are discommoded by the scheme. This scheme has been frozen for quite some time and it is hoped this review will come forward, but I have my doubts. For example, one gentleman, who has just turned 50, suffers from idiopathic Parkinson’s disease, dystonia, which is severe cramping, and dyskinesia, which is an involuntary movement.
He applied for the certificate in June 2018. The medical officer assessed him at home and told him on the day that he would not qualify under the criteria. He received the refusal letter on 27 November 2018. He was told he would not qualify until the criteria change. This gentleman had to get a loan to buy an automatic car as he was no longer able to drive a manual vehicle. No supports were available for this man and his family even though he had a registered carer.
Another example is a woman in her late 40s who is registered with the Irish Wheelchair Association and was refused a primary medical certificate. She had an accident in 2007 and has had multiple back surgeries to allow her to be able to walk. She has bolts and screws all over her back. If she was to lie down on a floor, she would not be able to get back up. She is in chronic pain, unable to work and finds walking a challenge. The last operation she had was in 2015. She lost the use of her left leg for over a year but movement has partially returned. She is unable to use public transport. This is a scheme she would benefit from but she does not satisfy the criteria. She has applied many times and been refused.
There is no review process for these applications. An applicant can appeal but will have to travel to the Disabled Driver Medical Board of Appeal in Dún Laoghaire for a hearing. Before Covid, it was taking a year for appeals to be heard and at that stage, when people are in chronic pain, they cannot travel what is a long distance in some cases. A review system should be set up and made accessible in each county, similar to the social welfare appeals that are called for oral hearings.
In September 2019, the Minister for Finance stated that he had no intention of reviewing the criteria that allowed people to qualify for the scheme. A new functional scheme needs to be put in place without delay because there are many people who would benefit. As a society, we should make sure people benefit from this scheme and contribute to our society by being able to purchase vehicles and secure transport for themselves.