I propose to take Questions Nos. 845 and 846 together.
Under the Health Act 1970 (as amended), eligibility for a medical card is based primarily on means. The Act obliges the HSE to assess whether a person is unable, without undue hardship, to arrange general practitioner services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure.
However, every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from, the social and medical impacts of an illness.
The issue of granting medical cards based on having a particular disease or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.
However, I also recognise that patients require a responsive and compassionate health system to meet their medical needs, particularly in cases of terminal illness. I am therefore pleased to confirm that the Government recently agreed to introduce an administrative arrangement for up to 12 months on an interim basis, that will enable persons who have been certified by their treating Consultant as having a prognosis of 24 months or less, to be awarded a medical card. These applications will not require a means assessment nor will they be reassessed.
Furthermore, since 2015 medical cards are awarded without the need of a financial assessment to all children under 18 years of age with a diagnosis of cancer, for a period of five years.
With regard to the cost of providing a medical card in the manner sought, this information is not readily available at this time.