HSE’S BUREAU FOR PARISH PUMP POLITICS

100 hours a week spent answering TDs’ enquiries on medical cards

ALMOST 100 HSE man-hours a week are spent on a dedicated hotline for politicians to make representations for medical and GP cards.

An Irish Mail on Sunday investigation into political interference in the application process also reveals that Taoiseach Leo Varadkar, when he was health minister, intervened more than 450 times in the medical and GP card process. This is

twice the rate of interventions by current Health Minister Simon Harris.

An analysis of records for the past threeand-a-half years shows politicians across all parties are lobbying to get medical or GP visit cards for applicants – most of whom are their constituents – despite both schemes having strict rules of entry.

The dedicated service, called the Oireachtas Contact Channel, is run by a third party on behalf of the HSE – as is the administration for the two card schemes. It was set up in 2011 in the midst of economic hardship.

A HSE spokeswoman said: ‘The resources required to service the volume of contacts through the dedicated Oireachtas Contact Channel is equivalent to 2.5 full-time staff.

‘The dedicated Oireachtas enquiry line was established following the centralisation and administration of medical card and GP visit card eligibility in July 2011. It is a managed service on behalf of the HSE based in Waterford.’

She explained its purpose: ‘The function of this line is to provide a dedicated contact channel for Oireachtas members to facilitate engagement with the National Medical Card Unit.’

Based on a 37.5 hour average working week in the HSE, this means that on average nearly 94 weekly working hours are spent dealing with queries. Technically such queries are not meant to influence the scheme.

The service has cost in the region of €433,000 thus far with the HSE being billed as per the amount of representations received and the time taken to deal with them.

More than 135,000 representations have been made by politicians – by phone, letter and email – in the past three-and-a-half years. However, Dr Pádraig McGarry, chairman of the Irish Medical Organisation GP Committee, insists politicians must stay out of the process for it to be fair and transparent: ‘While a level of discretion is required in the system… politicians should not get involved in trying to influence this discretion.’

A spokesman for Mr Varadkar downplayed the Taoiseach’s tally saying he had merely been seeking updates on card applications. However, he refused to comment on whether the Taoiseach had ever made a representation on behalf of someone who had been refused a GP or medical card.

In July, HSE chief Tony O’Brien wrote in the Sunday Business Post of the difficulty of reforming the healthcare system due to political intervention. He said: ‘Attempts to tackle these hard decisions require a type of political courage that is not often apparent. As the truism goes – all politics is local.’

In the 12 months since the present Dáil convened, 31,624 representations were made by politicians to the dedicated unit.

Michael Healy-Rae made the most. The Kerry TD has totted up 2,341 representations by either phone, email or letter since the general election. That’s more than double the number made by Donegal TD Charlie McConalogue – who comes in second place with 1,138 representations.

Mr Healy-Rae defended his tally insisting he deals with each one personally. ‘Everybody I help is in genuine need of a medical card. I deal with them all personally.’

Asked how he finds time in his busy schedule to deal with all the representations himself, Mr HealyRae said: ‘I start very early in the morning and I go until late at night seven days a week.’

Earlier this year hundreds of applications to obtain and renew medical cards and GP visit cards for under-sixes and over-70s were delayed due to staff shortages.

During his 22-month tenure as health minister, Mr Varadkar made 427 phone calls, sent 60 emails and wrote four letters on behalf of individuals he felt should be awarded either a GP visit card or a medical card. That equates to more than 22 representations a month.

However his interest waned once he left his position in Health – his rate of representations fell to slightly more than one a month.

A spokesman for the Taoiseach said Oireachtas members are encouraged by a unit within the HSE to make representations on behalf of the public.

‘The assessment of GP and medical card applications is carried out by the Primary Care Reimbursement Service based on specific criteria. All ministers for Health regularly receive a significant volume of representations and correspondence from members of the public and other public representatives enquiring into the status of their applications. The PCRS therefore has a dedicated Oireachtas enquiry line for public representatives to make such representations.

‘Recently the PCRS actually encouraged ministers, TDs and senators to make greater use of this service… The PCRS was never asked to grant a card where it was not felt to be necessary.’

The IMO’s Dr McGarry said: ‘Medical cards are allocated on the basis of means testing with a limited number of discretionary cards… In many cases they [politicians] may not be aware of the clinical or socio-economic factors involved with a particular patient. The discretion should be based on the clinical judgement of a GP combined with their knowledge of the patient and their circumstances.

In his first year as Health Minister, Simon Harris made 35 calls, sent 100 emails and wrote one letter – a total of 136 representations – slightly more than 11 a month. That’s more than double the number he made as a TD or as junior finance minister when he made only 5.5 representations a month.

A spokesman for Mr Harris said: ‘The minister, as a public representative, regularly seeks updates for individuals on medical card or GP visit card applications, as do all TDs and senators.’

The five junior health ministers have also been very active: Helen McEntee made 724 representations; Marcella Corcoran Kennedy made 128; Finian McGrath made 95, and Catherine Byrne made 51.

Ms McEntee – who has since moved to Foreign Affairs – defended her high volume. ‘Twenty of those could be for one person which, to me, shows that we’re following up and doing our job. The numbers went up when I was minister because I was getting contacted from people from all over the country.’

Fianna Fáil TD Stephen Donnelly – who made three representations since the election – said: ‘I think it is legitimate for a TD to make representations on behalf of people when the system is not working properly.

‘However, I don’t think it is appropriate for members of the executive to be making representations.’

Between March 2016 – when the Dáil convened – and May 2017, 35,546 representations were made.

Service just for politicians has cost about €433,000 22 representations a month by Varadkar