I welcome the delegates from the HSE. I do not agree with the main principle of their argument and I will tell them why. It is vital that this matter be addressed. It is bad enough to introduce a system for the over-70s that does not work as perfectly as we would have liked — we would not be here today were it not for that — but it is worse to introduce it for all 1.6 million medical card holders. One should regard this as an opportunity to be constructive collectively.
When I read Mr. Burke's statement, all I could say was that he was simply not listening. When he refers to a "front office", is he speaking about one in Finglas or in the counties where medical cards have been processed to date? This is a fundamental question. Mr. Burke seems to say that there is help available and that there will be help available locally. Will he explain to the committee who will be mandated to give that help locally? If I have a problem with a medical card and am unable to fill out my application, what will be the position? Many applicants will not be able to apply on-line, although their relatives may be able to do so. Who would be likely to help an applicant for a medical card in County Galway, be that applicant under or over 70? This is a fundamental question and must be answered.
I was at a briefing meeting for the HSE west division a month ago and the various managers of the HSE's divisions were in attendance. While we all accept fully that these are difficult economic times and that resources are very scarce, it arose at the meeting that one of the major savings that would accrue would involve the relocation of staff from the medical card office to somewhere else. On the basis of the funding we were talking about, this indicated there would be almost nobody left. If that is the case in every location, who will I be able to meet? Who will be my guardian angel? If that guardian angel is in Finglas, I am doomed. The HSE was not able to handle the system for the over-70s and it certainly will not be able to handle it for 1.6 million medical card holders. It is simply not on.
My final point was alluded to by Age Action Ireland and Dr. Daly. All of us who have spent a lifetime dealing with applicants for medical cards understand fully that they have certain medical needs. Dealing with them is part of our job and all my colleagues have spent as much time on this as I have over the years. I do not have to tell Mr. Burke or Mr. O'Brien that, at a particular stage in one's life and the lives of one's family, no document ever printed is as important as a medical card. I know people who would be prepared to have money deducted from their weekly wage to retain their medical cards. It is that important to them, so much so that we could not possibly allow the HSE to continue with a system that has not worked for a year and a half or two years even though it was dealing with very limited numbers. The HSE is now to implement that system country-wide. Will the local community welfare officers have any say under any circumstances in so far as discretionary cards or information, including medical certificates that the medical profession must look after, are concerned?
I have many questions but do not want to take up the time of the committee. Will application forms filled by applicants, either on-line or directly, be sent to an address in Finglas directly rather than to the local area offices as the first port of call? The delegates know where I am coming from in this regard. If the applications are sent directly to Finglas, the local offices will have nothing at all to do with them. Why would one seek help from somebody who has not seen one's application form and who knows nothing about it?
My secretary and I spent 11 days trying to contact an official in Finglas whose number I was given by the Minister for Health and Children. I was told to ring the person as a public representative but could not make contact for 11 days. I rang staff in the HSE at every single level and have a document detailing my calls for anybody who wants to see it. Two officials at a very elevated level told me they did not see the communication from the Minister and asked me to fax it to them. In other words, they did not know the Minister had sent out a list so public representatives could contact a person in Finglas. We could not have trust in such a system.
I do not mind saying the granting of a medical card does not concern me and the delegates because, for the time being, at least, we will be paid for the work we do, but we must consider the poor person at the end of the line who must present himself to a doctor when he knows his medical card is gone. If he tries to ring Finglas, as directed, he cannot get the ear of anyone. I assume that the two delegates, who have spent a good deal of time in the HSE, understand the psychology involved and the pressure on people. If they do not understand it, we are going nowhere.
