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Medical Card Eligibility

Dáil Éireann Debate, Tuesday - 12 November 2013

Tuesday, 12 November 2013

Questions (449)

Tom Fleming

Question:

449. Deputy Tom Fleming asked the Minister for Health if he will issue discretionary medical cards to all children with long-term medical conditions such as cystic fibrosis, Down's syndrome, cancer and so on; and if he will make a statement on the matter. [47997/13]

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Written answers

Under Section 45 of the Health Act 1970, as amended, persons who are unable, without due hardship, to arrange a general practitioner service for themselves or their family qualify for a medical card. There is no automatic entitlement to a medical card for persons with a specific illness or disability.

Under this legislation, the determination of eligibility for a medical card is the responsibility of the Health Service Executive. Section 45 requires the HSE to have regard to a person's, and their spouse or partner's overall financial situation in view of their reasonable expenditure. The HSE gives effect to this legislation and Government policy through its Medical Card National Assessment Guidelines.

Where a person's income is in excess of the income thresholds set out in the National Assessment Guidelines, the HSE uses its discretion to grant a medical card to a person who is unable, due to undue hardship, to arrange a GP service. In doing so, the HSE is obliged to have regard to the financial situation and expenditure of the individual and his or her dependents.

The HSE has an effective system in place for the provision of emergency medical cards for patients who are terminally ill in palliative care, or who are seriously ill and in urgent need of medical care that they cannot afford. They are issued within twenty-four hours of receipt of the required patient details and the letter of confirmation of the condition from a doctor or a medical consultant. With the exception of terminally ill patients in palliative care, the HSE issues all emergency cards on the basis that the patient is eligible for a medical card on the basis of means or undue hardship, and that the applicant will follow up with a full application within a number of weeks of receiving the emergency card. As a result, emergency medical cards are issued to a named individual, with a limited eligibility period of six months.

For persons with a terminal illness in palliative care, no means test applies. Once the terminal illness is verified, patients are given an emergency medical card for six months. Given the nature and urgency of the issue, the HSE has appropriate escalation routes to ensure that the person gets the card as quickly as possible.

The Government is committed to introducing, on a phased basis, a universal GP service without fees within its term of office, as set out in the Programme for Government and the Future Health strategy framework. As announced in the Budget, it has been decided to commence the roll-out of a universal GP service by providing all children aged 5 and under with access to a GP service without fees. This will mean that almost half of the population will have access to GP services without fees. The Government is providing new, additional funding of €37 million to meet the cost of this measure.

The implementation of this measure will require primary legislation. The necessary administrative arrangements will be made during the course of 2014, when the specifics of the legislation are known.

The introduction of a universal GP service constitutes a fundamental element in the Government's health reform programme. The current Government is the first in the history of the State to have committed itself to implementing a universal GP service for the entire population. A well functioning health system should provide equal access to health care for its patients on the basis of health needs, rather than ability to pay. The principles of universality and equity of access mean that all residents in Ireland should be entitled to access a GP services that is free at the point of use.

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