Alex White (Dublin South, Labour) | Oireachtas source

I thank the Deputy for raising this matter.

More than 1.8 million medical cards have been issued to individuals, the highest number in the history of the State. It represents an increase of approximately 500,000 since the end of 2008. It is expected that the provision of GP services and prescription drugs under the general medical services scheme will cost almost €2 billion in 2012.

As the Deputy is aware, medical cards are provided for persons who, under the provisions of the Health Act 1970, in the opinion of the Health Service Executive are unable, without undue hardship, to arrange GP services for themselves and their dependants. Under the legislation, determination of eligibility for a medical card is the responsibility of the HSE. The assessment for a medical card is determined primarily by reference to the means, including income and expenditure, of the applicant and his or her partner and dependants. Under the legislation, there is no automatic entitlement to a medical card for persons with a specific illness such as cancer. There is, however, a provision for discretion by the HSE to grant a medical card in cases of undue hardship where the income guidelines are exceeded. The HSE set up a clinical panel to assist in the processing of applications for discretionary medical cards where there are difficult personal circumstances.

On the fast-tracking of medical card applications for certain categories, it is important to point out that the HSE already has an effective system in place for the provision of emergency medical cards for patients who are terminally ill, or who are seriously ill and in urgent need of medical care that they cannot afford. Emergency medical cards are issued within 24 hours of receipt of the required patient details and letter of confirmation of the condition from a doctor or medical consultant. This can be initiated through the local health office by the office manager who has access to a dedicated fax and e-mail contact within the PCRS. As a result, there are no plans to establish a new unit given that this regime is in place.

With the exception of terminally ill patients, the HSE issues all emergency medical cards on the basis that the patient is eligible for a medical card on the basis of means or undue hardship and that the applicant will follow up with a full application within a number of weeks of receiving the emergency medical card. As a result, emergency medical cards are issued to a named individual, with a limited eligibility period of six months. The arrangement is slightly different for persons with a terminal illness. No means test applies to an application by a terminally ill patient. Once the terminal illness is verified, patients are given an emergency medical card for six months. Given the nature and urgency of the issue, the HSE has appropriate escalation routes to ensure the person receives the medical card as quickly as possible.

If an individual is unhappy with a decision made by the HSE on a medical card application, he or she has a right of appeal to the HSE appeals officer. The contact details of the appeals officer are provided by the HSE at the time of informing a person of a decision on his or her application. The appeal should be lodged within 21 days from the date of the decision.

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