Bernard Durkan (Kildare North, Fine Gael)
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338. To ask the Minister for Health the extent to which dental patients can have their requirements met and progressed as quickly as possible with particular reference to medical card holders; and if he will make a statement on the matter. [2335/24]

Stephen Donnelly (Wicklow, Fianna Fail)
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The Dental Treatment Services Scheme (DTSS) provides dental care, free of charge, to medical card holders aged 16 and over. Services available annually and on demand include an examination including preventative elements, two fillings, emergency extractions, and a scale and polish. More complex care, such as dentures, and a broader range of treatments for patients with additional needs and high-risk patients are available subject to the approval of the local HSE Principal Dental Surgeon.

Since May 1st 2022, there has been additional prevention treatments included and a 40-60% increase in fees paid to dentists across most treatment items. From January to October 2023, 142,450 additional treatments have been provided under the DTSS, with over 25,600 extra unique patients treated when compared with the same period in 2022.

I am aware that there are some towns with no or limited DTSS dentists that have sufficient capacity to accept new patients. Where access to a dentist is difficult, local HSE services assist patients who make enquiries and make lists of DTSS contractors available to medical card holders. In exceptional circumstances, the HSE assists patients to access emergency dental treatment by directly contacting private contractors or arranging treatment to be provided by HSE-employed dentists.

The Government is committed to fundamentally reforming dental services, including the DTSS, through implementation of the National Oral Health Policy, Smile agus Sláinte. My Department is working closely with the HSE to ensure the establishment of focused structures to drive implementation of the Policy. The HSE has now appointed a Strategic Reform Lead to drive Policy implementation across the organisation and to move forward in 2024 with developing new services for both adults and children in line with the Policy. This will include work on planning new services for medical card holders.

While it will take a number of years to bring reform to complete fruition, there will be an early emphasis in implementation on addressing the current issues, including the reform of the provision of services for medical card holders.

Bernard Durkan (Kildare North, Fine Gael)
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339. To ask the Minister for Health to indicate the extent to which eligibility for medical cards for those diagnosed with serious or life threatening illness can be upgraded to take account of the individual circumstances of their case not based on financial eligibility but hardship grounds; and if he will make a statement on the matter. [2336/24]

Stephen Donnelly (Wicklow, Fianna Fail)
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Medical Card provision is primarily based on financial assessment. In accordance with the Health Act 1970 (as amended), eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold.

The issue of granting medical or GP visit cards based on having a particular disease or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.

However, 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. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face 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.

The HSE also has a compassionate system in place for the efficient provision of medical cards in response to emergency situations i.e., where persons are in need of urgent ongoing medical care or when a patient is receiving end of life treatment. In these cases, a medical card is issued within 24 hours of receipt of the required patient details and completed medical report by a healthcare professional. In addition, since March 2021, persons who have been certified by their treating Consultant as having a prognosis of 24 months or less are now also awarded a medical card on an administrative basis. This measure delivered the Programme for Government commitment to extend eligibility for medical cards to persons with a terminal illness and work is continuing to develop a legislative framework to underpin this administrative scheme. Medical cards awarded on end of life grounds are never re-assessed by the HSE thereby providing reassurance and comfort to patients and their families.

Separately, I can advise the Deputy that, since 2015, medical cards are awarded without the need of a financial assessment to all children under 18 years of age with a diagnosis of cancer. Further information can be found on the HSE’s website at www2.hse.ie/services/schemes-allowances/medical-cards/other-types-of-medical-card/emergency-medical-cards/.

I can assure the Deputy that, to ensure the medical card system is responsive and sensitive to people's needs, my Department keeps medical card issues under review and any changes are considered in the context of Government policy and other issues which may be relevant.