Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I thank the Deputies for raising this issue. The HSE has a system in place for the provision of medical cards in response to an emergency situation for persons with a serious medical condition in need of urgent or ongoing medical care that they cannot afford and for persons in palliative care who are terminally ill. These cards are issued within 24 hours of receipt of the required patient details and a letter which confirms the medical condition from a doctor or consultant.

With the exception of terminally ill patients, all medical cards granted in an emergency are issued on the basis that the patient is eligible for a medical card on the grounds of means or undue hardship and will follow up with a full application within a number of weeks of receiving the medical card eligibility. It is also useful to note that in July 2015, the Director General of the HSE made a decision to award medical card eligibility to all children under 18 years of age with a diagnosis of cancer with the card to be held for a period of five years. It is undoubtedly important that the medical card application system is responsive and sensitive to people's needs, especially arrangements relating to the issuing of medical cards on a discretionary basis. To that end, the HSE has sought to implement revised processes to provide a more compassionate and more efficient process in the assessment of medical card applications. Such measures include the development of a burden of illness questionnaire which is now being rolled out in selective circumstances where the assessing doctor in the HSE's national medical card unit requires a more comprehensive assessment of an applicant's medical and social circumstances and any resulting undue financial hardship. In addition, in January this year, the new streamlined online medical card application system was launched. This will enable applicants to find out immediately if they are eligible for a medical card and will bring considerable benefits for people in turnaround times, convenience and security. Implementation of the measures above will aid the HSE's national medical card unit in providing an enhanced service to applicants, ensuring that the application process is as efficient and timely as possible.

It is nonetheless important to note that eligibility for a medical card remains primarily on the basis of financial assistance. This position was endorsed by the HSE's expert group on medical need and medical card eligibility which examined the issue of awarding medical cards on the basis of illness. That group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility and that a person's means should remain the main qualifier for a medical card. This position remains unchanged. To summarise, I recognise that patients require a responsive and efficient health system to meet their medical needs, which may often be required urgently. The processes in place in the HSE for granting an emergency medical card, the new measures of the burden of illness questionnaire and the online application system are aiding the national medical card unit to provide an enhanced service to applicants, ensuring that the application process is as efficient and timely as possible.

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