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, they 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 medical card system is now operating in a more sensible and sensitive manner. Greater discretion is clearly being exercised by the HSE because the number of discretionary medical cards in circulation has increased by about 50% - from about 52,000 in mid-2014 to nearly 79,000 at the end of January this year.
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 disease in this context.