Alex White (Dublin South, Labour) | Oireachtas source

I thank Deputy Nash for raising this matter.

Medical cards are provided to persons who, under the provisions of the Health Act 1970, are in the opinion of the HSE unable, without undue hardship, to arrange general practitioner, GP, services for themselves and their dependants. The assessment for a medical card is determined primarily by reference to the means including the income and reasonable expenditure of the applicant, his or her partner and dependants.

Medical card and GP visit card eligibility is subject to periodic assessment review by the HSE to determine a person's continuing eligibility to be approved for a medical card or GP visit card under the general medical services scheme. This can either be on the basis of a self-assessment completed by the card holder or a full review assessment conducted by the HSE.

In the former case, the card holder is simply asked to declare whether his or her circumstances have changed to an extent likely to affect their continuing eligibility to be approved for a medical card. A person who answers "No" to this question on the returned review form will have eligibility renewed for a further period. A person who answers "Yes" is required to provide the details of current circumstances relevant to conduct a full assessment of eligibility.

In cases where a full review of eligibility is undertaken, the review proceeds with an assessment of household means to determine if the applicant is within the income limits to qualify for a medical card or GP visit card. If a review application is assessed to be ineligible on the basis of means for both a medical card and GP visit card or means assessed eligible for a GP visit card only, and the application also includes other medical, social or financial details that do not form part of the means assessment, the application will then be considered on discretionary grounds for a grant of a card under the undue hardship-undue burden provisions of the medical card scheme of assessment.

Having completed a full assessment of a review application, a letter issues to the applicant advising of the decision on the application. If a review application is assessed ineligible or eligible for a GP visit card only, the letter issuing informing the applicant of this decision will include an explanation of how the application was assessed and the details of the means assessment calculated on the application. In addition, the letter will notify the applicant of the details should he or she wish to appeal the decision or provide additional relevant information for a further review assessment.

Notwithstanding the above practices adopted by the HSE in informing an applicant on the outcome of the assessment of the review application and how this decision was concluded, an applicant can appeal this decision or exercise the right under section 18 of the Freedom of Information Act to be provided with a statement as to the reasons for decisions or actions that causes the withholding of a medical card or GP visit card eligibility to the individual concerned.

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