While the number of medical cards issued where discretion was involved has fallen in recent years this is not as a result of a change in policy or a deliberate targeting of discretionary cards. Rather, it is attributable, in the main, to the fact that many people, who previously were marginally over the qualifying means thresholds, have subsequently been granted medical cards because they now fall under those means thresholds. Of the discretionary cards in circulation in 2011, less than one-tenth have been found to be ineligible for a medical card on review.
Minister Reilly and I are conscious of the difficulties faced by the relatively small number of people who have been found to be ineligible. At his request the HSE is currently examining how individuals, who are not entitled to a medical card, could still receive services that meet their needs. This examination relates to all of the services and supports provided by the HSE and with regard to as much flexibility as is available and at a local level. In addition, additional information will be provided and local information points will be established at major health centres around the country, where members of the public can obtain comprehensive information and support in accessing their full range of supports and entitlements from the Health Services. The objective is to maximise the supports available for patients and families.
Appropriate notice is also being considered as part of this review for existing medical card holders who may no longer be eligible on renewal - but where serious medical conditions or profound disability continues to exist in the household.
The clear intention is to maximise the supports that can be provided in each case to the fullest extent possible. The HSE is seeking to find the best way to achieve this in order to ensure families will receive the support they need.