Under the relevant legislation, there is no automatic entitlement to a medical card for persons with specific illnesses. The HSE has, however, discretion to award a medical card to avoid undue hardship, even where the person exceeds the income guidelines. At Minister Reilly's request, the HSE set up a clinical panel to assist in the processing of applications for discretionary medical cards, where a person exceeds the income guidelines but there are difficult personal circumstances, such as an illness.
The processing of medical cards at a national level, rather than at a local level as before mid-2011, ensures that all people are assessed in a similar and fair manner when applying for a medical card. The consideration of discretion is now standardised and operates in an equitable manner. The medical card scheme is now underpinned with a stronger foundation which enables better governance, more transparency and efficient modern processes. Under these processes, nobody who is entitled to a medical card will lose it or be refused one.