Dáil Éireann Debate, Wednesday - 17 January 2024
1523. Deputy Colm Burke asked the Minister for Health if he will take the necessary steps to ensure that all heart failure patients are eligible for a medical card and to remove prescription charges, in light of the significant financial pressure faced by sufferers and the anxiety caused by a condition that results in the death of over one in three sufferers within five years; and if he will make a statement on the matter. [56633/23]
View answerMedical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold.
The issue of granting medical or GP visit 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, 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 an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.
The HSE also has a compassionate system in place for the efficient provision of medical cards in response to emergency situations i.e., where persons are in need of urgent ongoing medical care or when a patient is receiving end of life treatment. In these cases, a medical card is issued within 24 hours of receipt of the required patient details and completed medical report by a healthcare professional. In addition, since March 2021, persons who have been certified by their treating Consultant as having a prognosis of 24 months or less are now also awarded a medical card on an administrative basis. Medical cards awarded on end-of-life grounds are never re-assessed by the HSE thereby providing reassurance and comfort to patients and their families.
Since 2022, under the Drugs Payment Scheme (DPS), no individual or family pays more than €80 a month towards the cost of approved prescribed medicines. The DPS is not means tested and is available to anyone ordinarily resident in Ireland. The DPS significantly reduces the cost burden for families and individuals with ongoing expenditure on medicines. Individuals may also be entitled to claim tax relief on the cost of their medical expenses, including medicines prescribed by a doctor, dentist, or consultant. Relief is at the standard tax rate of 20%.
Medical card holders under the age of 70 years, are charged a prescription charge of €1.50 for each item. This is up to a maximum of €15 per month, for each person or family. Medical card holders over 70 years of age, are charged a prescription charge of €1.00 for each item. This is up to a maximum of €10 per month, for each person or family.
This Government has put a significant focus on improving access to and the affordability of healthcare services, advancing substantial policy, legislation and investment to deliver expanded eligibility. I can assure the Deputy that, to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues, including prescription charges, under review and any changes are considered in the context of Government policy, annual budgetary estimates process and other issues which may be relevant.
