Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

We have jumped forward significantly in the questions.

I thank the Deputy for his question and recognise his ongoing advocacy on this topic, in particular to ensure that as many people as possible have access to medical cards and, or, GP cards. Medical card provision is primarily based on financial assessment by the HSE, with each applicant assessed on qualifying financial thresholds in accordance with the Health Act 1970. The issue of granting a medical or a GP visit card based on having a particular disease or illness, which is part of the Deputy's question, was examined in 2014. The HSE's expert panel on medical need and medical card eligibility concluded that there was not an ethical basis to list medical conditions in priority; in other words, there is no hierarchy of suffering. We have had very constructive and well-intentioned debate in the House over many years; for example the call comes up as to whether patients with a cancer diagnoses should automatically get a medical card. While one would love on a human level to cover everybody's costs when they get a diagnosis of cancer or something else, the expert group came back to say that there was no ethical justification to say "Yes" if a patient is diagnosed with cancer, and "No" if he or she is diagnosed with motor neurone disease. Therefore, we have to stay away from a hierarchy of disease. Essentially, the most transparent and the most ethical and equitable way to do it is to base it on income thresholds. As colleagues will be aware, then there are particular circumstances in which patients who are particularly sick can make an additional application. One of the areas where we have extended it - and I credit John Wall for his tireless advocacy on this - was if somebody had a terminal diagnoses, we extended the diagnoses period from 12 months to two years. Critically, that treats all patients, all disease and all sickness in the same way.

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