Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

Medical card provision is primarily based on financial assessment. In accordance with the Health Act 1970, eligibility for a medical card is determined by the HSE, which assesses each application on a qualifying financial threshold. The idea of granting medical cards or GP visit cards based on any particular disease or illness has been considered. It is a topic we discuss regularly in the Dáil. There are Deputies, for example, who have made a very reasonable case for cancer care patients. The proposal is that a cancer diagnosis would trigger eligibility for a medical card.

This issue was looked at in detail by an expert group in 2014. The group concluded that it is not possible to list and prioritise conditions for medical card eligibility without creating risks of inequity by diagnosis or condition. As it was explained to me, we cannot create a hierarchy of disease. The expert group could not find a solid ethical approach that would justify saying "Yes" to cancer patients and neurological patients, for instance, and "No" to cardiovascular and diabetes patients. The group said it just cannot be done like that. We cannot create a hierarchy whereby one disease or illness is deemed to be more worthy than another.

While I fully appreciate the Deputy's question, which is one that is discussed quite regularly in the House, the consistent position, which we should maintain, is that eligibility is based on other criteria. There is the financial assessment, as we are aware. There are a lot of discretionary medical cards given out. I might come back to that in my next response.

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