As the Deputy is aware, the HSE's Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards on the basis of illness and concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. The Expert Group also concluded that a person’s means should remain the main qualifier for a medical card. This position remains unchanged.
However, it is undoubtedly important that the medical card application system is responsive and sensitive to people's needs, especially arrangements relating to the issuing of medical cards on a discretionary basis. To that end, the HSE has sought to implement revised processes to provide a more compassionate and more efficient process in the assessment of medical card applications. Such measures include the development of a Burden of Illness Questionnaire which is now being rolled out in selective circumstances where the assessing doctor in the HSE's National Medical Card Unit requires a more comprehensive assessment of an applicant's medical and social circumstances and any resulting undue financial hardship.
In addition, in January 2018 a new streamlined online medical card application system was launched. This enables applicants to find out immediately if they are eligible for a medical card and brings considerable benefits for people in terms of turnaround times, convenience and security. This measures aid the HSE's National Medical Card Unit to provide an enhanced service to applicants ensuring that the application process is as efficient and timely as possible.
With regard to persons suffering from cancer and other serious medical conditions the HSE also has a system in place for the provision of medical cards in response to emergency situations i.e. in circumstances where persons are in need of urgent or on-going medical care that they cannot afford and also for persons in palliative care who are terminally ill. These medical 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. With the exception of terminally ill patients, all medical cards, granted on an emergency basis, are followed up with a full application within a number of weeks.
I would also like to note that since 1 July 2015, the HSE adopted the position that all children under 18 years of age with a diagnosis of cancer are awarded a medical card. This card is valid for a period of 5 years.
While it is none the less important to note that eligibility for a medical card remains primarily on the basis of financial assessment, I do recognise that patients require a responsive and efficient health system to meet their medical needs, which may often be required urgently. The processes in place by the HSE in granting an emergency medical card, the online application system and the Burden of Illness Questionnaire are aiding the National Medical Card Unit to provide an enhanced service to applicants ensuring that the application process is as efficient and timely as possible.