middle-class forced to pay once again

The seven-year-old from Swords suffers from spina bifida and hydrocephalus; she has a brain shunt, catheter and cannot walk.

While Temple Street Hospital treats her conditions, as any good public health system should, there are understandably massive extra costs such as GP visits which Sophie needs far more often than most.

There the 'system' breaks down. Because Sophie's family are 'middle-class'. They earn money through hard work (her dad is in IT), pay taxes with other children to support, and they can't get a medical card for Sophie.

In fact, they can't even get a GP visit card, which is all they're asking for.

Mum is a full-time carer because that's what Sophie needs.

The reason is that, despite all the promises made both before the current Government got into power and since, medical card assessments are processed with financial means as the foremost criteria for eligibility.

After that comes how sick someone is. Sophie fails on both counts, so one is wondering just how bad things have to get before the State steps in.

The single biggest issue facing kids like Sophie is that 'financial' means is based not on hers (for she has none) but her parents. She loses out because dad works and pays the very taxes which support those who don't.

income

What of discretionary medical cards, which for all kinds of reasons, don't work. This is largely because 'discretionary' is by its very nature, undefinable.

It's a kind of touchy-feely thing that makes more sense in political heads than medical admin ones.

The HSE says: "Every effort is made to apply discretion whenever possible and to provide supports to those dealing with a serious illness ... however, given the financial means assessment, this is not always possible for those in the highest income brackets."

Ah right. Well of course, nobody wants fat cats and millionaires to get a medical card, so that makes complete sense.

But let's look at what constitutes "highest income brackets" for the HSE. It is a weekly income after tax of no more than €266.50 for a full medical card, while a GP visit card is only considered for those earning less than €400-a-week. That's €23,764 p.a.

That's far below the average industrial wage. If dad lived on benefits the family would qualify, even if they're above the limits. It's crazy.

What the Government has pledged to do is not to offer medical cards to sick children but to all the well children under six years.

But not yet. Indeed, not even soon, it seems.