Dáil Éireann Debate, Tuesday - 25 February 2014
657. Deputy Michael Healy-Rae asked the Minister for Health his views on whether it is fair, right and proper that all persons who are on a transplant list for any organ should automatically be entitled to a full medical card or a long-term illness card due to their medical condition; and if he will make a statement on the matter. [9117/14]
View answerUnder the provisions of the Health Act 1970 (as amended), eligibility for health services in Ireland is based primarily on residency and means. The Act provides that persons who are unable, without undue hardship, to arrange GP services for themselves and family qualify for a medical card. The HSE can only award medical cards in accordance with the Act and, therefore, it must assess applicants on the overall financial situation of the applicant and his or her dependants. The HSE gives effect to this legislation through its Medical Card National Assessment Guidelines.
While there is no legal basis for the HSE to award medical cards on the basis of a specific medical condition, the HSE has, however, discretion to grant a medical card in certain circumstances. If an applicant’s means are above the financial thresholds, set out in the national guidelines, the HSE examines for any indication of circumstances (medical or social), which might result in undue financial hardship in the arranging of medical services. Eligibility may be granted on a discretionary basis if these circumstances are such that a person cannot arrange GP services for themselves and their family without undue financial hardship.
Discretion must be exercised by the HSE but the fundamental provision in the 1970 Act is that a person is assessed on the basis of undue hardship in arranging a GP service, having regard to his or her means. The HSE must, of course, operate within the legal parameters as set out in the Act, while also responding to the variety of circumstances and complexities faced by individuals who apply for a medical card.
The HSE has a system in place for the provision of medical cards in response to an emergency situation for persons with a serious medical condition in need of urgent or on-going medical care that they cannot afford and persons in palliative care, who are terminally ill. These are issued within 24 hours of receipt of the required patient details and a letter which confirms the medical condition from a doctor or consultant.
With the exception of terminally ill patients, all emergency cards are issued on the basis that the patent is eligible for a medical card on means or undue hardship and 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. There are no proposals to change these processes.
