My Department provides funding in the region of €10m per annum, through the HSE, for targeted measures to improve the health status of the Travelling community. These include:
- primary healthcare projects, counselling services, family support programmes and men's health projects; dedicated public health nurses and related staff; and
- mental health promotion and suicide prevention services in a culturally sensitive manner, to reduce the stigma associated with mental health.
In addition, the Department of Justice and Equality's National Traveller and Roma Inclusion Strategy also details HSE-specific actions. Of particular note is the commitment by the HSE to develop a National Traveller Health Action Plan to continue to address the specific health needs of Travellers. The Plan is expected to be finalised by the end of this year.
Regarding eligibility for health services in Ireland, this is based primarily on residency and means, in accordance with the provisions of the Health Act 1970 (as amended). The Act provides that persons who are unable, without undue hardship, to arrange GP services for themselves and family can qualify for full eligibility (a medical card). The HSE's Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards and concluded that a person’s means should remain the main qualifier for a medical card. This position remains unchanged.
However, the HSE may exercise discretion and grant a medical card or general practitioner card, even though an applicant exceeds his or her income threshold, where he or she faces difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.
Sláintecare provides the framework within which a system-wide health reform programme will be advanced, including a phased expansion of eligibility to move towards universal healthcare. To that end, it will be necessary to review the current eligibility framework for all services and consider different options that will enable a phased expansion of universal access to a prescribed range of services. These options will take account of the ability of the health system to meet the increase in demand that would be expected, including the resource requirements needed from a workforce and service delivery perspective, as well as the impact on the effective management of the financial resources of the total health service.