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Cards group ‘in place for two years’

05 Feb 2015

Dr Mary Sheehan, Chair, Clinical Advisory Group

It was difficult to get people to sit on the new medical card Clinical Advisory Group, established last week, “because it is a complicated area”, the Minister for Health has revealed.

The group’s objective is to come up with a set of guidelines to assess how unwell a person is and what burden of illness they face. The new Group will have three months to draw up revised guidelines for discretionary medical cards and will remain in place for two years.

“We are never going to assume that we get this exactly right,” said Minister Dr Leo Varadkar. “Medicine changes and we want to have the Group there to keep reviewing the guidelines as things develop. Should a very difficult case arise, a HSE official or medical officer can go to the Group for advice.”

The medical card controversy of last summer required the Government to reconsider how the whole system works, and the appointment of this Clinical Advisory Group follows the report of an Expert Panel on medical card eligibility under Prof Frank Keane last year.

The criteria for awarding discretionary medical cards have been widened and it is planned to widen them further, to take into account medical hardship and the burden of an illness on individuals and their families — regardless of their income. “This is very much a work in progress,” Dr Varadkar said.

Currently, where a medical card is awarded on the basis of a terminal illness, it is no longer reviewed. Routine reviews are not done on discretionary medical cards. There is now “broader and wider discretion” — even when somebody is over the income limit. If there are significant medical expenses, people can qualify for a medical card.

The number of discretionary medical cards in circulation has recently increased by 50 per cent, from 50,000 early last year to 75,000 now. When discretionary Doctor Visit Cards are included, there are 108,000 discretionary cards in existence. “Though it is improving, the situation is far from perfect yet,” said Dr Varadkar. The appointment of the Clinical Advisory Group is the next step in the reforms, he explained.

The Clinical Advisory Group will be chaired by the ICGP’s Dr Mary Sheehan GP, and members include clinical experts from specialist services and professions as well as patient representatives. The Group will initially meet on a monthly basis and will provide an interim report within three months and a quarterly progress report thereafter to the National Director of Primary Care.

The Group also includes: Dr Jerome Coffey, Director National Cancer Control Programme; Dr Denise McDonald, Paediatrician, Tallaght Hospital; Virginia Pye, Director, Public Health Nursing, Longford Westmeath; Dr Mary Stains, Medical Director, Stewart’s Hospital; Dr Margo Wrigley, National Clinical Advisor and Group Lead, Psychiatry; Emma Benton, Therapy Professions Advisor; and Dr Margaret O’Riordan, Medical Director of the ICGP.

Pharmacist Mel Cox is also a member of the Group, as is Peter Fitzpatrick, Our Children’s Health, and Patricia Ryan, Patients for Patient Safety Ireland. An additional member is to be nominated by physicians in geriatric medicine.

Gary Culliton

Click here to view the full article which appeared in Irish Medical Times