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THE ISSUE OF discretionary medical cards was placed firmly on politicians’ agendas this week as amid claims of a conscious policy by government to withdraw cards from people who are chronically ill.
Twice in the last fortnight, Fianna Fáil has raised the issue at Leaders’ Questions while a private members’ motion debated in the Dáil on Tuesday and Wednesday this week called for, among other things, politicians to note “this deliberate targeting was approved by the Minister for Health in the 2013 HSE Service Plan”.
The government flatly denies this and on each occasion the matter has been raised the Taoiseach and government ministers have insisted that any notion of deliberate targeting of the sick is just not true.
Enda Kenny told the Dáil on Wednesday that there are 22,000 fewer discretionary medical card holders. But over 22,500 individuals who were previously recorded as qualifying for a discretionary card now get an ordinary one because they meet the income eligibility requirements.
“I don’t accept at all your assertion that there are any changes here,” the Taoiseach told Fianna Fáil leader Micheál Martin.
On 24 September he made the same points at question time while also highlighting that there are more medical card holders now than at any time in the history of the State.
During the debate on Fianna Fáil’s motion this week there were contributions from all sides of the house with TDs relaying the grim experiences of constituents with chronic and life-threatening illnesses who have been refused medical cards or went through a tortuous process to get one.
Here are a selection of the stories that were put on the Dáil record by TDs Billy Kelleher, Barry Cowen, Robert Troy, Sandra McLellan and Paul Connaughton:
“A young boy of six years of age who has profound intellectual and physical disabilities, who is confined to a wheelchair, who does not have the use of his limbs, who is incontinent and who cannot communicate. The card relating to this boy was withdrawn as part of a review.Following a protracted row with the HSE, a discretionary card was awarded for a period of six months. This is in respect of a child with profound intellectual and physical disabilities and all of the other problems to which I refer.”
“A boy who will be three years old in December, who has down’s syndrome, who is profoundly deaf, who requires substantial daily care, who has serious medical needs and who has an intellectual disability. This child’s medical card was also revoked.
Another of those on the list I possess is a man who has lung cancer, who was recently diagnosed as bipolar and who half of his right lung removed in March. His medical card, which was granted to him three years ago, was withdrawn.
Another man is over 70 years of age. This individual has terminal stage cancer, he is being fed by means of a percutaneous endoscopic gastrostomy, PEG, tube, he can no longer move or speak, he is confined to a special wheelchair, he has dementia and we was awarded a GP-only card.
Helen has held a full medical card for a number of years as she suffers from severe rheumatoid arthritis and attends St Vincent’s Hospital regularly. Her application came up for renewal in April and was refused. We requested a review, but it was disallowed. We then requested an appeal and only yesterday we received word that she was granted a doctors only medical card. This lady is on medication that costs more than €100 a week, which she does not have the means to meet.
Anne has always held a full medical card on medical grounds as she suffers from osteopenia and severe rheumatoid arthritis. Her case came up for review in April. When her application was refused, it went to review but that, too, was refused, and it was later refused on appeal.
Jack is aged nine. He has held a full medical card. He has multiple disabilities, including cerebral palsy and a hearing impairment. Jack’s medical card came up for review in February and he was awarded a doctor visit card. We requested a review and the original decision was upheld. We therefore appealed the decision and that was again upheld.
Jeanette works in the HSE … has always sought not to be an economic burden on the State. She has had and retains her own medical needs which surpass her means, now that she has dependents, namely her partner … whom is unemployed and her miracle baby [now 12 months old]. [That baby unfortunately] is in constant need of specialist medical attention. All the relevant details pertaining to this case, economic and medical, are on the file.I find it distressing that this application process has been so poorly dealt with, considering the amount of communication Jeanette has had with the relevant sections dealing with her application. She was informed over the phone that the cards were granted only to be informed the opposite days later. It is unbelievable that Jeanette should be forced to avail of my … office in seeking to have the only decision possible in this case, arrived at.
Bryn Bailey is a young boy of six years of age from my constituency. When his card expired he was refused the discretionary medical card even though his circumstances were worse than when it was granted. Only on appeal and after ferocious lobbying by public representatives for four months did he even receive the six month emergency card, which is a mere stop gap…… Young Bryn faces challenges in his young life we can only begin to imagine. Among other things, he suffers from epilepsy, spastic quadric paresis, mitochondriaI disorder, global developmental delay, hypertrophic cardiomyopathy, precocious puberty, chronic constipation, hypothermia, microcephaly and right renal calculi.
He has no means of communication, no use of his arms or legs and is wheelchair dependent. His parents have had to make huge sacrifices to support and care for him. He requires 24 hour care seven days per week. His parents are his carers.
I have tabled a parliamentary question on the case of a 13 year old boy. When he was diagnosed with autism at four years of age, he received a medical card. It was renewed every two years until August of this year when, despite there being no change in his medical condition – if anything it had worsened – or in his parents’ financial position, something else that had worsened, his application was refused. That refusal is being appealed.
A lady who was paralysed in an accident last year was granted a medical card in early 2013 following a mammoth battle. She had been rendered tetraplegic after the accident and required extensive rehabilitation in the National Rehabilitation Hospital. She was informed in July of this year that the medical card was cancelled. An application to have the card reinstated was turned down. The matter is now under appeal. In the meantime, she has been left without a card.
A man who is on the transplant list as he awaits a kidney transplant and attends dialysis three days a week. Now that he does not have a medical card, the cost burden on his family is proving great. Surely it does not take weeks for a medical assessor to determine that someone on the transplant list has exceptional medical needs.
Happy Birthday man
I wonder what he would have to say about a country with a the homeless epidemic raging and hundreds of thousands of families crushed under spiraling rents and mortgage debt as the state facilities vulture funds masquerading as charities to snap up homes at fire sale prices?
Or a state which is systematically dismantling the public health hand education systems using a lack of funding as justification while they fight tooth and nail to ensure Apple hangs on to €19 billion in dodged taxes?
Are you suggesting Apple broke the law? If you have information pertaining to the appeal you should report it to the Gards immediately.
@Fiannaoicht: Er, the EU has judged that they broke the law.
Have you been asleep for the last three months?
Note use of the word ‘appeal’. RTFM.
@Fiannaoicht: Would you ever FO back to your box you amadan
@Fiannaoicht:
This Irish Times article sums it up.
The Double Irish scam which the likes of Google use to funnel their profits offshore to avoid tax is technically legal but of course deeply immoral. The double Irish is a 2 company structure where one company pays Intellectual Property royalties to a second company which is registered in ireland but tax resident in some tax haven the Cayman Islands or Bermuda etc.
Apple in contrast used a single company (Single Irish) structure and the IP royalties were moved from one branch of the company to another offshore/HQ branch which was tax resident nowhere. This is the selective benefit that Commission has picked up on and has ordered Apple to pay the €13 billion in back taxes.
Both the double and single Irish are disgusting financial 3 card trickery to allow the corporates to dodge their taxes but only the single Irish is in breach of E.U. law. It looks like our Revenue Commissioners didn’t advise Apple well enough on how to legally avoid their taxes.
A great visionary I would love to hear his take on the seagulls running the shop over the last 15 years!!!
Happy birthday
@⚡ Seánie ⚡:
Do we attribute the lies, spin, greed and desperation to this man too?
A true public servant who enriched our economy. He deserves all the plaudits he is receiving. He makes mediocrities of most of our senior politicians/ civil servants down through the years. Happy 100th birthday!
Let’s not get too dewy eyed. The capitalist model which Whitaker espouses has failed millions of Irish people with mass poverty, unemployment and emigration being the norm for most of the history of the state. It has served the pampered corporate, political, legal and administrative class very well though which is the reason that Whitaker is revered by this group.
An overview of Irish capitalism since Independence.
“Unemployment and emigration were near constant features in southern Ireland from so-called independence right up to the ‘Celtic Tiger’. At its heart, this was down to an inability of capitalism to create jobs, and develop industry (for reasons I will come on to later). In fact, overall the number of jobs declined – with slightly less employed in 1992 than 1922, a shocking indictment of capitalism1. Whilst the number of jobs did fluctuate slightly, it remained largely stagnant around the one million mark.
This is not to say there were not new jobs being created, but that those created were really just replacing jobs lost elsewhere in the economy. So, for instance, in the 1960’s over 118k new jobs were creatred, but there was a corresponding loss of 116k jobs, meaning only a net job creation of 2k .2 And whilst there was slight net growth in the number of jobs in the 60’s, and the 70’s, this was countered by net job loss in the 50’s and 80’s.
The result of this job stagnation was that a huge amount of young people were ‘surplus to requirement’ for Irish capitalism, which was unable to provide them with work. This meant that mass unemployment was an “outstanding feature” of the Irish economy, according to the famous government paper by TK Whitaker in 1958, and it’s twin – mass emigration. Consistently from 1922 to 1992 Ireland’s rate of unemployment was one of the worst in Europe, and in that period 1.7m people emigrated.3
Again, this is not to say there was no let up, or the entirety of this period was the same. At times, one or other of these features was less prominent. However, the underlying stagnation in jobs meant that when one receded it was usually accompanied by a rise in the other. So, for instance, in the 1970’s emigration fell to 10k a year, and there was in fact net immigration for the first time in the history of the state.4 However, at the same time, unemployment was on the rise. During the most serious crises, both emigration and unemployment rose hand in hand, such as in the 1980’s when unemployment reached almost one in five, and 1% were emigrating every year.”
Benit, did you not read the part about emigration, poverty and unemployment before he came along! Are you that thick?
@Benjy Mooney:
How many times have you changed your name.
Ireland of the 50s was multiple times worse off than today. If people think it is not well there is no point in even auguring the point.
He saw the CB as a controlling mechanism and was disgusted how it lost its way. He indirectly argued against the Euro.
You will forgive me for copy and pasting.
“Whitaker’s long-held concerns about income inequality and the detachment of the financial markets from a sense of societal responsibility or accountability are more relevant than ever today.
In the 1980s, he asked: “Is it little more than a fiction that parliament and government are sovereign? Does the State’s power rest precariously on day-by-day tolerance of its authority by powerful sectional interests? Are governments nowadays to be compared to the totally deaf Beethoven in his later years, just being allowed to go through the motions of conducting the orchestra while the real control is being exercised elsewhere?
Said in the 80′s,the problem of the last 20 year’s was there were no Whitakers in a position of power to shout stop. He had vision from the economy, to regulation, North and even Irish Language.
An overview of Irish leftist socialism since Independence :……………………………………………………….
………………………………………………………………………………………………………………………………………….
…………………Nothing to see here.
@dublinlad:
Mass poverty, unemployment and emigration continued despite the policies that Whitaker implemented and remain to this day with a lack of a home being the most acute form of poverty.
Did you miss this part?
“In fact, overall the number of jobs declined – with slightly less employed in 1992 than 1922, a shocking indictment of capitalism”
@ktsiwot:
“Whitaker’s long-held concerns about income inequality and the detachment of the financial markets from a sense of societal responsibility or accountability are more relevant than ever today.”
The problems of inequality, the parasitic nature of the finance sector and the amorality of profit seeking are inherent to the capitalist system. Whitaker condemned the symptoms while promoting the cause.
@ktsiwot:
The limitations of the FDI strategy from the link:
“With the turn away from protectionism in the 1950’s came a new focus on attracting foreign direct investment, to act as a motor for the economy where domestic investment had failed. This was moderately successful for a period, but highlighted another key problem that the Irish economy has faced: the inability of reliance on FDI to provide sustainable growth.
The years 1960 to 1979 was the initial ‘golden age’ of this policy, during which time there was a rapid rise in manufacturing output, and a re-balancing of Irish exports from primary goods to secondary, with foreign direct investment the driving force. Between 1958 and ’73 manufacturing output grew by 6.7% a year, with the numbers employed in the sector growing at 2.4% a year too. By the 1970’s multinationals employed 68,500 working in manufacturing, the proportion of national production being exported had doubled to over 40%, with merchandise exports finally exceeding livestock.13
This FDI-led growth, however, proved to be sporadic, and weak. For one, much of the investment was reliant on heavy subsidisation, grants and tax incentives. It was also unstable, so whilst there was growth in FDI in the 60s, and much of the 70s, it stalled from 70 to 73 and declined throughout the 80s.14 On each occasion, international events played the key role, as export oriented FDI depended not just on the situation in the country the company is from, but where they are hoping to export to. The Irish economy also found itself lagging behind countries, for instance, even during this ‘golden age’, Irish growth rates were far below the rest of Europe.
The growth that did take place, was also quite shallow, both in terms of the type of investment and in terms of its impact on the domestic economy. Much of the companies that invested were in so-called footloose industries such as chemicals and computers, which don’t require intensive investment locally outside of construction costs. Instead the main costs were materials, so the companies were relatively free to move on as they saw fit. Linked to this, once companies set up in Ireland, there was very little re-investment or expansion from them, meaning that in order to keep up investment levels there was a need for a constant flow of new companies in. For this reason, the industrialisation that did take place has been described as ‘dependent industrialisation’.15
Most importantly, the impact of this rapid expansion in exports and level of manufacturing output on the domestic economy itself was actually very shallow. Almost all the materials used in production were imported, and almost all the products were exported, most starkly demonstrated by US pharmaceutical companies who imported 97% of materials and exported 98% of their outputs16. Other than things such as legal and financial services therefore, there was actually very few ‘linkages’ with the rest of the economy. The profits that were made were minimally taxed, and 98.5% were repatriated out of the country. And whilst jobs were created, multinationals only employed a third of the manufacturing workforce, but accounted for the majority of output and exports, and the vast majority of the profits”
@Benjy Mooney:
This must be the 3rd or 4th time you have changed the first name, Why?
@ktsiwot:
My username name is irrelevant, as is yours.
Are you unable to address the substantive point? That is the failure of Whitaker’s vision of capitalism.
In summary:
“From ‘independence’ to the ‘Celtic Tiger’; both reliance on domestic and international capitalism proved incapable of providing a stable basis for a strong economy. Domestic capitalism – under both protectionism and free market competition – failed to develop viable, competitive industry. And the reliance on export oriented multi nationals, with very few linkages to the domestic economy, resulted in only shallow and unstable development. Throughout it all, the Irish economy remained generally weak and backwards suffering from mass unemployment and emigration.”
Fu___ck off benjy
@Benjy Mooney:
There are many issues with capitalism, as even Mr Whitaker suggests in one of my posts. However if we want to live in the 1950s with protectionism and little or no trade (only agriculture to the UK), we would still be in horse and carts. We live in a very interconnected world (maybe too interconnected) . For what it is worth I will take Mr Whitaker’s vision any day ahead of the rubbish you spout. You have some good examples from your previous name regarding economic theories you can have Zimbabwe, Venesuala, USSR. Don’t give the rubbish about economic equality in Cuba there is no economy to have equality their.
@Benjy Mooney: Ah jaysus there’s three of you :(
@ktsiwot:
The article also fails to mention Whitaker’s admiration for Margaret Thatcher’s vision:
“In 1993 he suggested Margaret Thatcher’s “most creditable and enduring achievement was to re-establish the supremacy of government and parliament over sectional interests”
By “sectional interests” of course Whitaker means the working class. The capitalist class interests were staunchly protected and advanced by Thatcher’s government and every British government since.
Great article about a great Drogheda man who is under valued and under appreciated.
@Peter Matthews: He was born in Down!
One story from is biography that i liked was. Himself and Jack Lynch were walking into Stormount for a meeting. Ian Paisley was protesting outside chanting No popery here. Jack Lynch turned to Whitaker and asked him. Which one of us do you think he thinks is the pope.
He certainly did the State some service.
Deserves his pension, unlike quite a few of the politicians he had to work with.
Is he looking for a job by any chance?
Great article. Somebody on journal can actually write in English.
Great man TKW always read many articles about him ! He will we deserve the cheque from MD !
Just in time for Christmas. Lovely.
€2,450….received.
@Greg — Did he also get a complimentary poem penned by the little fella? :p
More articles like this please! We need to know who and what got Ireland to where it is now. We also need journalism with Whitaker’s spirit of integrity. If you don’t provide it, we’re left with the trolls and commentators keen to preach cynicism, half-truths and despair. Thanks for enlightening us and Happy Birthday to the man himself.
Our economy is built on the guidelines of Whitakers white paper even today. A massive contribution to our move from an agricultural to industrial based ecenomy.
Happy birthday and thank you
Happy birthday Dr Whittaker. Have a lovely day and thanks for all you did for our country.
Imagine, a civil servant with the best interests if his country at heart. He was probably the last one…all self serving now…
@ eircodes, If he was working today he’d be subject to the same slander and name calling as everyone else unfortunately!
He had a nice signature (on the pound notes)
Wonder what he thinks of trumps plans?
@Maurice Bourke: I’m right down the road from Trump and even I’m clueless to his plans. Nice article.
Proof that fossil fuels are net benefit to people if you can afford to have access to them
have your say