Dáil Éireann Debate, Thursday - 27 November 2014
131. Deputy Ciarán Lynch asked the Minister for Health if under the revised conditions for the issuance of medical cards, he will consider the inclusion of chronic asthma sufferers aged 70 years and over; and if he will make a statement on the matter. [45599/14]
Amharc ar fhreagraUnder the Health Act, 1970, eligibility for a medical card is founded primarily on the undue financial hardship test and every application must be assessed on that basis. Under the legislation, determination of an individual’s eligibility for a medical card is the responsibility of the HSE. The 1970 Health Act obliges the HSE to assess whether a person is unable, without undue hardship, to arrange GP services for themselves and their family, having regard to their overall financial situation and reasonable expenditure. There is no automatic entitlement to a medical card for persons with specific illnesses, or with a disability.
The system of assessment for eligibility for those 70 years of age and over is based on significantly higher gross income limits rather than the standard net income thresholds. This advantageous arrangement for persons aged over 70 years has facilitated a much greater share of this cohort qualifying for a medical card compared to the general population as a whole. In the main, persons in the over-70s age cohort do not have the same outlays and expenses as those under 70 years of age who are assessed on a means basis. However in circumstances where their income exceeds these limits persons aged over 70 years may still be eligible for a medical card where discretion is exercised where they face undue hardship in arranging medical services as a result of medical or social circumstances.
The Deputy is aware that the Director-General of the HSE established an Expert Panel to examine and recommend the range of medical conditions that would be considered as a basis of eligibility for health services. The Expert Panel report was presented to Minister Varadkar last month. The Expert Panel concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. It also concluded that a person’s means should remain the main qualifier for a medical card and recommended that the existing eligibility assessment should be extended beyond financial hardship to include an assessment of the burden of a medical condition, but it noted that there are significant challenges to including such an assessment. It is however recognised by Government that there is a need for discretion and sensitivity in assessing eligibility, which will take into account an individual's medical condition and needs, rather than a list of specific medical conditions. In that context, the Government has approved a number of immediate improvements that the HSE is making to the medical card system.
