Dáil Éireann Debate, Thursday - 9 July 2015
206. Deputy Brendan Griffin asked the Minister for Health if he will introduce an automatic entitlement to full medical cards for children in receipt of a domiciliary care allowance; and if he will make a statement on the matter. [28064/15]
Amharc ar fhreagraUnder the provisions of the Health Acts, medical cards are provided to persons who are, in the opinion of the HSE, unable without undue hardship to arrange GP services for themselves and their dependants. In the assessment process, the HSE can take into account medical costs incurred by an individual or a family. Where deemed appropriate in particular circumstances, the HSE may exercise discretion and grant a medical card even though an applicant's means exceed the prescribed threshold. Where a person does not qualify for a medical card, they may be provided with a GP Visit Card, appropriate therapy or other community supports or drugs.
The Domiciliary Care Allowance (DCA) payment is made by the Minister for Social Protection to carers in respect of a child at home under 16 years of age with a severe disability, where it has been determined that the child requires ongoing care and attention, substantially over and above the care and attention usually required by a child of the same age. Eligibility for the DCA is not based primarily on the medical or psychological condition, but on the resulting lack of function of body or mind necessitating the degree of extra care and attention required. As such it is not possible to say if a particular child or any particular medical condition or disability will qualify for a payment under the DCA scheme.
Out of an approximate population of 1 million people under the age of 16 years, almost 450,000 held a medical card or a GP visit card. Approximately 29,000 children qualified for the DCA payment in 2014. It is estimated that about two-thirds of children qualifying for a DCA payment also hold a medical card. In addition, from 1 July 2015, all children under the age of 6 years are entitled to access a GP service free of charge, as part of the first phase of introducing a universal GP service in Ireland.
At the time of the publication of the report of the Expert Panel on Medical Need for Medical Card Eligibility the HSE announced a range of actions to enhance the operation of the medical card scheme and make it more sensitive to people’s needs. The medical card system is now operating in a more sensible and sensitive manner. The HSE is exercising greater discretion, as is evident in the increase in the number of discretionary medical cards in circulation which have grown by 67% from 52,000 in mid-2014 to 87,000 by mid-2015.
On foot of the Keane Report, the Director General of the HSE established a Clinical Advisory Group (CAG). The CAG is to provide clinical oversight and guidance to the operation of the medical card system. This is with a view to ensuring that the relatively small percentage of cases requiring the recognition of the burden of a medical condition over and above financial hardship can be accommodated. The CAG is continuing its consideration of the medical card assessment process to provide for the measurement of the burden of disease.
