The Government is committed to introducing a universal GP service without fees on a phased basis. The first phase will be for all children under six years of age and all persons aged 70 and over to have access to GP care without fees. These arrangements will come into operation in quarter 2 of 2015, subject to the conclusion of contractual discussions. I expect the Bill to extend GP services without fees to all over-70s to be published in March. These measures represent a major step on the way to universal health care. The Government recognises that different age groups have different health care needs and abilities to access services and that children and older people have particular needs in this regard.
The medical card system is fundamentally based on means, and this position has obtained for more than 40 years. However, the Government recognises that the health service needs to be responsive to the circumstances of people with significant medical needs. In November 2014 the Minister for Health and I announced a series of measures to enhance the operation of the medical card scheme and make it more sensitive to people's needs, especially where serious illness is involved. Where deemed appropriate in particular circumstances, the HSE may exercise discretion and grant a medical card even though an applicant's means exceed the prescribed threshold. Where a person does not qualify for a medical card, he or she may be provided with a GP visit card, appropriate therapy or other community supports or drugs and appliances under the long-term illness scheme, where the qualification criteria are met.
The HSE has recently established a clinical advisory group for medical card eligibility. The group will provide oversight and guidance to the operation of a more compassionate medical card system and will focus initially on the development of a framework for assessment and measurement of the burden of illness in this context.
The Government is reforming the system of health service eligibility that it inherited and is seeking to make it fairer. For many years we have had universal eligibility for acute hospital services, but free access to the first and most effective point of contact with the health service - that is, GPs - has only been provided on a public basis to those on very low incomes. The provision of universal GP access through greater public investment in primary care services is a critical reform in resolving inequities and rebalancing our services towards earlier prevention. The introduction of universal GP access for the youngest and oldest members of our community is an important step in the phased implementation of these reforms.
