Dáil Éireann Debate, Tuesday - 18 October 2016
553. Deputy Bernard J. Durkan asked the Minister for Health the extent to which the standardised procedures for processing medical card procedures could be improved with a view to a more expeditious process, with particular reference to patients suffering from a life-threatening or terminal illness; and if he will make a statement on the matter. [30972/16]
Amharc ar fhreagraUnder the Health Act, 1970, 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 dependents and every application must be assessed on that basis. In accordance with the Act, the assessment for a medical card is determined primarily by reference to the means, including the income and expenditure, of the applicant and his or her partner and dependents. Where deemed appropriate in particular circumstances, the HSE may exercise discretion and grant a medical card even though an applicant exceeds the income guidelines but where they may face difficult financial circumstances, such as extra costs arising from illness.
It should be noted that 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.
Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting information and documentation to fully take account of all the relevant circumstances that may benefit them in the assessment, including medical evidence of cost and necessary expenses.
It is important that people with medical needs should be able to access necessary assistance in a straight forward manner. It is clear greater discretion is being exercised by the HSE because the number of discretionary medical cards in circulation has increased from about 52,000 in mid-2014 to over 110,453 as of 1st September this year. This followed the measures announced by my predecessor Minister Varadkar, when the "Keane" Report of the Expert Panel on Medical Need for Medical Card Eligibility was published. The "Keane" Report found that it is not feasible, desirable or ethically justifiable to list medical conditions for medical card eligibility. On foot of the publication of the report, the HSE established a Clinical Advisory Group to develop clinical oversight and guidance for the operation of a more compassionate and trusted medical card system. Its establishment followed the completion of the work of the Expert Panel on Medical Need for Medical Card Eligibility and demonstrates the HSE's commitment to the development of a medical system which is responsive and considerate of an applicant's particular circumstances.
The HSE has a system in place for the provision of medical cards in response to an emergency situation for persons with a serious medical condition in need of urgent or on-going medical care that they cannot afford and persons in palliative care, who are terminally ill. With the exception of terminally ill patients, all medical cards, granted on an emergency basis, are issued on the basis that the patient is eligible for a medical card on the basis of means or undue hardship, and will follow up with a full application within a number of weeks of receiving the medical card eligibility. These cards are issued within 24 hours of receipt of the required patient details and a letter which confirms the medical condition from a doctor or consultant. For terminally ill persons, no means test applies.
