The Department of Health was accused yesterday of "culling" medical cards from marginalised groups in "a very ruthless manner" in an attempt to make up the deficit it faced when it underestimated the cost of giving medical cards to all those over 70.
The Irish Medical Organisation's honorary treasurer, Dr Martin Daly, said over 14,000 medical cards were "culled" over the past year alone. He said some 67,000 were taken away since 1997.
Marginalised groups lost out, he said, because the income guidelines for medical card eligibility did not keep pace with inflation.
Dr Daly said this "sinister" exercise of "culling" medical cards from the needy was happening at a time when GPs were, on a daily basis, having to write begging letters to health boards to see if medical cards could be provided on a discretionary basis to families encountering real hardship. "It's degrading and no way to run a health service," he said.
He added that a major anomaly in the system was the fact that the Minister for Health, Mr Martin, had directed that medical cards not be removed from social welfare recipients, but some people who were working but taking home less than families on social welfare still couldn't get medical cards.
Furthermore, he said, some over-70s were "relatively well-off" compared to those on low incomes.
The cost of giving free medical care to all over-70s, regardless of their income, was underestimated by more than €50 million when the measure was announced in December 2000.
The incoming president of the IMO, Dr James Reilly, said the only equitable way to hand out medical cards in a just society was to means-test for them. He said there should be no blanket entitlement to medical cards for under-5s or other groups.
The doctors were speaking at an IMO press conference in Dublin, where details of the organisation's annual conference in Killarney, which takes place in two weeks, were announced.
At the conference, the IMO will again urge Mr Martin to honour a pledge made in the health strategy in 2001 to extend medical card eligibility to an extra 200,000 people.
Dr Reilly said waiting lists could be cut if patients had access to earlier interventions through primary care. Giving ready access to primary care was also more cost effective. "For every €1 spent on prevention you will save €12 to €20 on treatment," he said.
A spokesman for the Department of Health said that due to the "prevailing budgetary situation" it was not possible to meet the commitment to grant extra medical cards this year but that the Government remained committed to honouring the promise.