Medical cards and severe illness

Sir, – I read with interest the letter by Laverne McGuinness, the chief operating officer of the Health Service Executive, indicating that those with severe and life-threatening illnesses will continue to receive medical cards on discretionary grounds (July 22nd).

However, I am puzzled by the disparity between the policy as enunciated, and our recent experience in the motor neurone disease clinic. Within the past few months, I have drafted many letters to the HSE in support of appeals by people with advanced motor neurone disease who have been refused medical cards. I have also written many letters for people in the terminal stages of their illness, whose medical cards have been withdrawn for reasons that are entirely unclear.

Motor neurone disease is a rapidly progressive and terminal condition that requires integrated community-based care, including GP services, access to public health nursing, physiotherapy, occupational therapy, speech and language therapy and nutritional advice. These services are not available in the private sector, and limiting access to medical cards also limits access to essential community-based support and equipment, with ensuing hardship for patients and their carers. This in turn leads to increased hospitalisations and reduced quality of life in the terminal stages of illness.

Following Ms McGuinness’s letter, I sincerely hope that everyone with motor neurone disease will now be issued with a medical card without further delay. – Yours, etc,

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Prof ORLA HARDIMAN,

Whitebeam Road,

Clonskeagh, Dublin 14.