I wish to raise the need for the Minister for Health to explore the possibility of reviewing medical card guidelines for people with spinal injuries who wish to take up work but who see the potential loss of their medical card as a significant disincentive to taking up employment. I thank the Minister of State, Deputy Finian McGrath, for taking this matter today.
This important issue has been raised with me by several constituents. From my discussions with them, it is evident that those who have suffered spinal injuries face ongoing medical challenges for a lifetime which come with a high cost. Those medical challenges can include pain, urinary tract infections and pressure sores which need to be kept in check by doctors and nurses. These can also present significant financial challenges. Without a medical card to help offset significant medical costs, people with spinal injuries may not receive the vital care and attention they need.
In the context of this discussion, it is clear many people with spinal injuries are caught between a rock and a hard place. Currently, those who want to seek employment fear losing the medical card. If they are not working, they face being caught in a poverty trap. It is not just about the cost of living, keeping food on the table, a roof over their heads and paying the bills. Associated health supports and services, essential to their everyday living, also need to be considered. Without a medical card, there are many costs to be covered such as medicine, physiotherapy, wound dressing, regular visits to the GP and the National Rehabilitation Hospital in Dún Laoghaire, along with medical equipment such as wheelchairs, shower chairs and having this equipment serviced. As one person with a spinal injury said to me, they are nervous about taking up employment because they fear losing the medical card. This can be a great cause of stress.
A spinal injury, unfortunately, is an injury for life, presenting ongoing challenges which I have outlined. These concerns relating to employment and holding on to a medical card were highlighted in the 2017 Government report, Make Work Pay for People with Disabilities. The report identified the main barriers which impede people with disabilities from fulfilling their employment ambitions. Not surprisingly, the potential loss of a medical card was identified as the single most significant disincentive to taking up employment. While people on a disability payment for at least a year can retain a medical card for a further three years when they return to work, the report confirmed that those with lifelong conditions generally do not see this temporary retention as sufficient in that it does not offer security of continued access to the medical card and the vital supports it brings.
I strongly believe we must explore the possibility of reviewing the medical guidelines for people with spinal injuries. These are people who want to work and to contribute economically. However, the potential loss of the medical card creates a significant barrier for them to take up employment.