Madam, - I must concur with the Irish Medical Organisation's assessment that medical card entitlement needs to be readdressed urgently (Health Supplement, October 5th). In my own field of dermatology the management of chronic skin disease is fraught with difficulty in the low-income group ineligible for the medical card.
These people face the daily struggle of choosing to manage their disease or to manage their other financial concerns. When this struggle becomes unmanageable it becomes a problem for the healthcare system and society as a whole. Far too often, I am faced with patients who have had to skip medication and have not sought help from their GP because of financial pressures. This often results in the patient needing intensive medical and nursing intervention, and in some instances hospitalisation.
Needless to say, this crisis intervention has a domino effect on hospital waiting-lists, the more so for being a recurring theme. Furthermore, there is an additional knock-on effect on the economy in that recurring disease results in lengthy absences from work and reduced income for already stretched household budgets.
I was heartened to hear that the Department for Health and Children is aware of this issue and is seeking to address it; however, intervention is needed now, so that the daily hardship these people face is ended. There is a growing need for innovation in managing the healthcare needs of marginal groups outside the medical card scheme network, especially those with chronic disease.
Addressing this issue will pay double dividends, in that making chronic disease management more effective and this will benefit both health care provision and the economy. - Yours, etc,
SHEILA RYAN, Dermatology Nurse Specialist, St Vincent's University Hospital, Elm Park, Dublin 4.