Mr. Shaun Flanagan:

The HSE put in place a clinical advisory group based on the Keane report. The group came up with three reports on identifying and being more responsive to need. One report assisted the primary care reimbursement service, PCRS, in designing a burden of illness questionnaire to maximise the capture of cost and challenges in relation to medicines. The findings were addressed.

The Keane report also flagged that the means assessment worked grossly for many people but the need base had to be better managed. The burden of illness questionnaire was a key change suggested but the clinical advisory group reported other changes to the HSE and the PCRS implemented most of the recommendations. Some of the report was made up of commentary rather than recommendations.

I flag the emergency application system which the Chair is probably aware of. It has a separate application form and is designed to fast-track individuals who urgently need a medical card and may not be in a position to submit a means test application. In the scenario in which there is a clear, medically defined requirement for an urgent medical card, a healthcare professional makes the application on his or her behalf which sets out the need and provides a medical report. We suspend the means test for six months. The system is for documented issues in which there is a medical need for a card but the person cannot engage with the process.