Michael Moynihan (Cork North West, Fianna Fail)
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9. To ask the Minister for Health to detail the number of discretionary medical cards he will restore; and if he will make a statement on the matter. [27060/14]

Michael Moynihan (Cork North West, Fianna Fail)
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Will the Minister for Health detail the number of discretionary medical cards he will restore and make a statement on the matter?

Alex White (Dublin South, Labour)
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The current eligibility system for health services, which has been in place since 1970, is based primarily on financial criteria. The Government has decided to develop a policy framework for providing eligibility for health services to take account of medical conditions. This will include new legislation, as appropriate, and a HSE clinical expert group to examine the range of conditions that should be considered as part of the process. The group has been asked to make an early report to the Minister for Health in the autumn.

The Government was concerned about the potential impacts on the health of persons with serious illnesses whose discretionary medical cards and general practitioner visit cards were refused renewal since the centralisation of medical card assessment in 2011. Therefore, in the context of the development of an eligibility policy, the Government decided that medical cards and GP visit cards are to be issued to persons with a serious medical condition or disability who had the renewal of their discretionary card refused by the HSE having completed an eligibility review during the period 1 July 2011 to 31 May 2014.

The arrangement applies in the following circumstances: during the period in question the person held a medical or GP visit card issued on a discretionary basis but the HSE made a decision to refuse its renewal on foot of a completed eligibility review; the person completed the review process during that period - that is, provided the information and documentation required to assess eligibility; and the person has a serious medical condition, one which required the case to be referred to a medical officer as a part of the review process.

It is anticipated that approximately 15,300 cards will be issued to people with serious medical conditions as part of this process. It is estimated that 5,288 people will be issued with a discretionary medical card, 2,899 people will be issued with a discretionary GP visit card and 7,118 people will be moved from a GP visit card to a discretionary medical card.

Michael Moynihan (Cork North West, Fianna Fail)
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Despite the replies to previous questions, major difficulties remain with what are perceived as the criteria for discretionary medical cards. This is the case even for applications that have gone in over recent weeks and in respect of which people have been diagnosed with serious illnesses and have submitted their documentation. There is a major issue with the process. Reviews are still ongoing. We have people coming into our office who have a major difficulty with the process.

The Minister of State gave us figures and he alluded to changes in legislation. This matter is a priority and legislation should be before the House as soon as possible. The Minister gave us figures and stated there would be a report in the autumn, but that is far too late for the families concerned. These people have major medical difficulties and in some cases a terminal diagnosis. They are still waiting for medical cards and there is toing and froing with the HSE seeking clarification on pieces of paper and so on. It needs to be treated with more urgency than is the case at present.

Alex White (Dublin South, Labour)
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The determination of the basis for the awarding of medical cards on medical grounds, as opposed to means grounds, which has been the case since 1970, will be dealt with absolutely comprehensively through the expert panel. If we are to determine a basis for awarding a medical card where a person has a medical condition or an illness then there must be some basis for determining what that will be and what the grounds will be. The Government has correctly commenced its consideration of the matter by putting together an expert panel of medical professionals. These are people who work in medicine - clinicians who are in a position to list conditions and make an assessment of conditions and illnesses appropriate for access to services under the scheme. That is the job this panel will have to undertake.

I agree with Deputy Moynihan that this should be resolved as quickly as possible. However, there is no use in saying the legislation should be before the House as soon as possible unless the Deputy can suggest to me or unless someone has a view on what the legislation should contain. We want to get the legislation correct and we must decide the criteria for the awarding of what one might term medical medical cards.

Michael Moynihan (Cork North West, Fianna Fail)
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The Government and the Minister have constantly referred to changing the legislation and so on, but the practice in the HSE, which dates back to the health boards, has been to grant medical cards on a discretionary basis. I am unsure why the Minister of State is saying there no basis for it in law.

I have no wish to mention the exact details because the families would know that I am quoting their files on the floor of the Dáil, but some people who have been diagnosed with serious illnesses have approached me in the past week or two. The medical card section of the HSE is looking for pieces of paper with minute clarifications on this and that and clarifications in respect of income details. The people concerned may be on social welfare. This practice is continuing. As late as yesterday we had a major difficulty with a family of a person with an illness. The HSE was looking for scraps of paper, for want of a better term, and it is intolerable.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Deputy, please. You are over time.

Alex White (Dublin South, Labour)
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The human situation that the Deputy describes is extremely frustrating. I understand what the Deputy is saying - I imagine all Members understand. The Government is now dealing with the issue of access to services. I am referring to necessary access that people with medical conditions and illnesses must have, even if they are over the means test limit. All Governments have been sticking to the 1970 Act, dating back almost 45 or 50 years, and held that unless a person satisfies the mean test, he does not get access to services. That is what we are trying to change and that is what we will change. That is what we are going to do properly and comprehensively through this review. The Government has indicated that it will come back to the Oireachtas in early course. We hope we will be able to do so, and we intend doing so in the autumn.