Dáil Éireann Debate, Tuesday - 25 February 2014
666. Deputy Kevin Humphreys asked the Minister for Health the position regarding the facilitation of better access to medical cards for patients with primary immunodeficiencies; and if he will make a statement on the matter. [9249/14]
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. Medical card applicants or their dependants, affected with primary immunodeficiency conditions, who submit supporting medical reports with an application for a medical card and who do not qualify for a medical card on an assessment of means, have the management of their medical condition considered during the assessment process to determine if the refusal of eligibility would result in undue financial hardship for the applicant or any dependants.
PCRS management has recently advised me that they have met with a number of health care professionals from Crumlin Children's Hospital who have specific responsibility for the treatment of children with significant primary immune deficiency disorders. PRCS management clarified the process by which the assessment of medical card applications is undertaken and the granting of eligibility under the Medical Card Scheme. The health care professionals were briefed on primary care services, available locally, to this cohort of patients under the auspices of other community health schemes and the pathways to access such services.
