Frank Feighan (Sligo-Leitrim, Fine Gael) | Oireachtas source

I thank the Deputy for raising this issue. He talked about issuing medical cards quickly and people having to supply information again. He has a unique view on the hospital making a decision. A time of illness is difficult and a cancer patient experiencing trauma, for example, needs compassion and needs the State to act as quickly as possible.

Person-centred care is a core value of the health service, whereby everyone living in Ireland and considered by the HSE to be ordinarily resident here is entitled to either full eligibility or limited eligibility for health services. Persons with full eligibility, namely medical card holders, can generally access a wide range of health services without charge. As of 1 November, there are over 1.56 million medical card holders and more than 533,000 GP visit card holders.

Eligibility for a medical card is provided on a statutory basis under the Health Act 1970 and is based primarily on means. The Act obliges the HSE to assess whether a person is able, without undue hardship, to arrange general practitioner services, having regard to his or her overall financial position and reasonable expenditure. Where individuals might be in excess of the medical card income threshold in the guidelines, every effort is made by the HSE to support them by taking full account of the difficult circumstances, such as extra costs arising from an illness. In such circumstances, the HSE may exercise discretion and grant a medical card. That said, it is vital that we do as much as possible to support people with difficult illnesses, including, where appropriate, through the provision of a medical card.

Regarding the particular matter raised by the Deputy, the HSE has guidelines in place on the provision of emergency medical cards to patients who are terminally or seriously ill and in urgent need of medical care they cannot afford. Instances where it would be appropriate to apply for emergency consideration include acute medical crises whereby access to services covered by medical card eligibility is required urgently and the client has no means to pay for them privately. Emergency medical cards are issued within 24 hours of the receipt of the required patient details and letter of confirmation of condition from a doctor or consultant. Medical card eligibility awarded in emergency circumstances is for a period of six months, following which time the client will need to complete a full means assessment, with the exception of terminally ill patients.

With the exception of patients who are terminally ill, all emergency medical cards granted are issued on the grounds that the patient is eligible for a medical card on the basis of means or undue hardship and will follow up with a full application within a number of weeks of becoming eligible. I am advised by the HSE that such medical cards are active on the system within 24 hours of the HSE national medical card unit receiving a medical report and completed application form from a healthcare professional.

I endeavour to ensure that the medical card system is responsive and sensitive to people's needs. My Department keeps medical card issues under review, and any proposals are considered in the context of any potential broader implications for Government policy, the annual budgetary Estimates process and legislative requirements arising. However, I do hear the Deputy. For every Deputy and Senator, medical cards can be a very difficult issue. It can be harrowing for those with a terminal or serious illness if they find it hard to get a medical card. We do need to do a little better.

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