Anne Rabbitte (Galway East, Fianna Fail) | Oireachtas source

I thank the Deputy for raising this matter, which I am taking on behalf of the Minister, Deputy Donnelly. I will stick to the script I have been given but perhaps the Deputy and I can have a conversation thereafter.

The Deputy may be aware that under the Health Act 1970, eligibility for a medical card is provided on a statutory basis 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. Persons with full eligibility, that is, medical card holders, can generally access a wide range of health services without charge. As of 1 December last year, there are over 1.56 million medical cardholders and over 535,000 GP visit cardholders. Where individuals might be in excess of the medical card income guidelines, every effort is made by the HSE to support applicants 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. I have yet to see that discretion exercised. It is also important that every effort is made to support people with difficult illnesses including, where appropriate, through the provision of a medical card. I can inform the Deputy that the HSE has systems in place to provide emergency cards to support people who are terminally ill or seriously ill and in urgent need of medical care that they cannot afford. For example, circumstances 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 same privately. The HSE has advised me that emergency medical cards are issued within 24 hours of receipt of the required patient details and letter of confirmation of condition from a doctor or consultant. With the exception of terminally ill patients, all emergency medical cards granted are issued for a period of six months. This is based on the patient being eligible for a medical card on the basis of means or undue hardship and following up with a full application within a number of weeks of receiving the medical card eligibility. l assure the Deputy that the Department of Health endeavours to ensure the medical card system is responsive and sensitive to people's needs. The 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.

The most striking piece of what I have read out to the Deputy related to the grant of emergency medical cards for six months with the exception of cases of terminal illnesses. Where a person has a life-altering condition or diagnosis, there is a period of time when filling out forms is not their priority. They are instead ensuring they are in the right space to receive the right care that gives them the time to adjust and understand the life-altering news they have received and its impact on their family. It is not only the individual who is affected. The wider family is also impacted. The HSE and the Department should be looking at that temporary emergency card. We do not want to create a hierarchy of conditions or anything like that. We are talking about life-altering conditions where people are undergoing treatment or need to recover or rehabilitate for six months, at which stage the process would be reviewed.

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