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Medical Card Reviews

Dáil Éireann Debate, Wednesday - 25 June 2014

Wednesday, 25 June 2014

Questions (8)

John Browne

Question:

8. Deputy John Browne asked the Minister for Health when he expects the thousands of discretionary medical cards withdrawn since 2011 to be restored; and if he will make a statement on the matter. [27064/14]

View answer

Oral answers (9 contributions)

The current eligibility system for health services, which has been in place since 1970, is based primarily on financial criteria. The Government has decided to develop a policy framework for eligibility for health services to take account of medical conditions, including new legislation as appropriate, and a HSE clinical expert group is to examine the range of conditions that should be considered as part of this process. The group has been asked to prepare an early report for the Minister for Health in the autumn.

The Government was very concerned about the potential impact on the health of persons with serious illnesses whose discretionary medical cards and GP visit cards had been refused renewal since the centralisation of medical card assessment in 2011. Therefore, in the context of the development of an eligibility policy, the Government decided that medical cards and GP visit cards were to be issued to persons with a serious medical condition or disability who had the renewal of their discretionary card refused by the HSE, having completed an eligibility review during the period from 1 July 2011 to 31 May 2014.

This arrangement applies in the following circumstances: during the period the person held a medical card or GP visit card issued on a discretionary basis but the HSE made a decision to refuse its renewal on foot of a completed eligibility review; the person completed the review process during that period - that is, provided the information and documentation required to assess eligibility; or the person has a serious medical condition which required that his or her case to be referred to a medical officer as part of the review process. It is anticipated that approximately 15,300 cards will be issued to people with serious medical conditions as part of this process. It is estimated that 5,288 people will be issued with a discretionary medical card, 2,899 people will be issued with a discretionary GP visit card and 7,118 people will be moved from a GP visit card to a discretionary medical card.

It is also recognised that a small number of individuals may not have been able to complete their review during the defined period due to circumstances relating to their medical conditions, such as hospitalisation or a change of residence during treatment. Therefore, the director general of the HSE may act on his own initiative, to take account of an ad misericordiam appeal on a case-by-case basis to issue a discretionary card to such a person where he or she has a serious medical condition.

People do not need to make an application to receive a card because the HSE is working through its database as quickly as possible to contact the people concerned over the next few weeks to inform them that their card is being issued. If people do not hear from the HSE by mid-July, they should contact it on its Lo-Call contact number.

Has this question been assigned to a particular grouping?

There is no grouping because it is grossly unfair to Deputies who are waiting for their questions that 30 questions might be taken in conjunction. The system is intended to apply fairly to everybody. When a question is reached, it is taken.

I thank the Minister of State for his reply. Over the past week the Taoiseach cited figures of more than 15,000 discretionary medical cards and 5,000 mercy cards. However, when I contacted the medical card section yesterday it had no information on the criteria or method for acquiring a mercy card. Many people with severe disabilities lost their discretionary cards, including people with spina bifida, Down's syndrome and cancer, resulting in severe financial hardship for the families concerned. How soon will cards be issued to such people, will they be given priority and will the cards be reissued automatically? Will the money spent over the last year by families who have lost medical cards be refunded?

In the first instance, it is not proposed to issue refunds in these circumstances. This problem will ultimately be resolved only through a change in the legislative basis for awarding medical cards. The Government has now set in train a process to achieve that intended outcome. With regard to the speed at which this will happen, the HSE is working as quickly as possible to contact those concerned. We estimate it will take a number of weeks to resolve the issue. It is not necessary for individuals to the contact the HSE because they can rest assured that their cases will be dealt with in accordance with the criteria published last week. However, if people remain concerned and they do not hear from the HSE by mid-July, they are free to contact it on the Lo-Call contact number.

I am disappointed that a refund is not being considered. I am aware of a large number of families in my constituency who are paying their chemists for drugs on a weekly basis because they were unable to pay the full amount up front. The Minister of State should reconsider the possibility of refunding such patients.

I understand the Deputy's point, but the cards were removed for proper legal reasons. I am not saying that did not affect the individuals concerned. In terms of the actual position of the time, the HSE applied the law correctly. As legislators, we are trying to change the law. People often ask us why we cannot change the law if it is against us on a particular issue. We are setting out to do that, and that is why the expert panel has been established. We look forward to receiving support from the Opposition in dealing with the issue.

However, for the moment, what the HSE has done - it has been fortified by the Government announcement in respect of a change of policy - is to move to a position, as it were, in which all further reviews are suspended. The circumstances relating to the return of cards were announced last week.

Can I ask a supplementary question?

Sorry; the time has expired. Six minutes are allowed.

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