Ciarán Cannon (Galway East, Fine Gael) | Oireachtas source

I thank Deputy Ó Fearghaíl for raising this matter, which I am taking on behalf of the Minister for Health, Deputy Reilly.

I advise the Deputy that, overall, nearly 44% of the national population has free access to general practitioner services under the general medical services, GMS, scheme. The HSE continues to issue medical and GP visit cards, with 2 million people currently having access to free GP care. This reflects an incremental annual increase and is 15% higher than the number at the end of end 2010. Far from cutting medical cards, the Government has provided funding to ensure an additional 250,000 people have been covered by the GMS scheme since it entered office.

As the Deputy will be aware, under the provisions of the Health Act 1970, the assessment for a medical card is determined primarily by reference to the means, including the income and expenditure, of the applicant and his or her partner and dependants. While people with specific illnesses such as cancer, multiple sclerosis or the other condition to which the Deputy referred are not automatically entitled to medical cards, the legislation provides for discretion by the HSE to grant a medical card where a person's income exceeds the income guidelines. The HSE takes into account a person's social and medical issues when determining whether there is undue hardship for a person in providing a health service for himself or herself or his or her dependants.

It is important to stress that the medical card system is founded on the undue hardship test. The basic infrastructure of the medical card system provides that medical cards are allocated to persons on the basis of their material circumstances as opposed to a particular illness.

The discretionary system is an exception to the general rule.

The HSE set up a clinical panel to assist in the processing of applications for such discretionary medical cards, where there are difficult personal circumstances. This approach recognises the need to have in place a standard process for considering applications in respect of people who, while over the income guidelines, require a discretionary assessment on the basis of illness or undue financial hardship. If the applicant's means are in excess of the medical card income guidelines, the deciding officer will consider whether to refuse would cause undue hardship. If the applicant fails to qualify for a medical card, the deciding officer will consider the applicant for a GP visit card. If the applicant's means are in excess of the GP visit card guidelines, the deciding officer will consider whether it would be unduly burdensome for the applicant to provide for GP services for himself or herself from his or her own resources.

The HSE, in exercising discretion, takes account of all the circumstances of an individual case - the nature and extent of personal, medical or social circumstances of the applicant and-or dependants. If granted, the card may also cover dependants. The HSE ensures that the system responds to the variety of circumstances and complexities faced by individuals in these difficult circumstances.

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