Belfast Telegraph

HSE warned over MS sufferer

The health service has been warned to change after a terminally ill multiple sclerosis sufferer was forced to prove her sickness to have a medical card renewed.

Tanaiste Eamon Gilmore said he was unhappy at the treatment of right-to-die campaigner Marie Fleming, whose partner Tom Curran was repeatedly asked for information on her condition.

In written exchanges with medical card auditors in the Health Service Executive (HSE), Mr Curran said he was forced to explain that a terminally ill disease does not miraculously go away.

The HSE claimed a review form was routine and prompted a request for extra information, but said it regretted the inconvenience.

Mr Gilmore said: "I think it does show that the system can be quite cold at times and I think that's something we have to address."

Ms Fleming is one of thousands of sick people being assessed for eligibility for free health care in a cost-saving crackdown.

The 59-year-old, who lost a Supreme Court challenge earlier this year to end her life with assistance, retained her medical card despite having to prove her eligibility.

No one medical condition ensures automatic entitlement to the card. It is based on means and an application is assessed by a panel of medics if a patient is just above the threshold.

Taoiseach Enda Kenny said he does not blame Mr Curran for being annoyed and warned that lessons need to be learned by health chiefs.

"A person does not become un-terminally ill," he said.

Ms Fleming, a former university lecturer and academic, was diagnosed with MS in 1986 and can only move her head. The mother-of-two is continuously fighting infections, lives in constant pain, cannot swallow and suffers choking sessions which she fears will kill her.

She is entitled to a full medical card which has in the past been renewed automatically.

The Taoiseach said if there were further calls from the HSE for her to prove her illness, the process must be changed.

"A person who is deemed and verified to be terminally ill is not suddenly going to have their medical condition changed," Mr Kenny said. "So there needs to be compassion and an effective understanding of how that card is to be renewed."

In a statement, the HSE said: "As soon as the HSE became aware that the individual has a terminal illness, steps were immediately taken to ensure eligibility remained in place.

"The medical card processing centre (PCRS) has a database of more than two million people and handles over 10,000 pieces of correspondence each week.

"A review form was issued as part of routine procedures, which prompted a request for some additional information. The HSE regrets any inconvenience the correspondence may have caused."

In her case against Ireland, the Attorney General and the Director of Public Prosecutions, Ms Fleming claimed section 2.2 of the Criminal Law (Suicide) Act, which renders it an offence to aid, abet, counsel or procure the suicide of another, is unconstitutional on grounds that it breaches her personal autonomy rights under the Irish Constitution and the European Convention on Human Rights.

Mr Curran had previously called on politicians, including Mr Kenny, to legislate for assisted suicide with necessary safeguards.

The Government announced in last month's budget plans to review the medical card process in a bid to hit a 113 million euro (£95 million) savings target.

Figures unveiled last week revealed 428,682 medical cards have been reviewed this year. The HSE said about 45,000 have been withdrawn since January 1.

Some 10,393 cards issued on a discretionary basis have been taken from patients and either replaced with GP cards, full medical cards or none at all.

Since October 1, 38,495 people have been removed from the system after their medical cards were found to have been inactive.

The HSE said it expects to have reviewed 600,000 medical cards by the end of the year.

About 35,000 of the 350,000 over-70s who have medical cards are expected to be moved to the free GP visit card, the HSE said.

Approximately 1.86 million people have a full medical card as well as 123,424 with a GP-only card.

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