Erin McGreehan (Louth, Fianna Fail)
Link to this: Individually | In context

I thank the Minister of State for being here. I will speak about medical cards specifically for cancer patients. I will ask the Department to do something really incredible for cancer patients, which is something we most definitely can fix. It is to simplify the medical card application for people with cancer. We already made adaptions to the application process, which worked well for Ukrainian refugees under the temporary protection directive, resulting in a streamlined system that cut through bureaucracy and guaranteed care but, for cancer patients, we can look to required clinical need. We did this at the time because we recognised that in crisis we need to adapt. Likewise, cancer patients are in a moment of crisis. They should be looked after and not put under financial strain.

Diagnosis brings fear, uncertainty, often financial hardship and severe hardship, yet in Ireland too many patients must navigate the maze of forms and means testing to get a medical card, despite overwhelming clinical need. We say we care about their well-being and then we ask about their bank statements. It is not care and can be incredibly cruel. The Irish Cancer Society has called explicitly for automatic medical cards from diagnosis until treatment ends. This is consistent with our values. We have extended this to children with cancer acknowledging the huge pressure that is put on families to care for someone going through treatment. We have discretionary cards but these are not automatically granted to all cancer patients. They are often reserved for those with terminal illnesses under a specific financial threshold. Some patients still face difficulties, even with these. It is very distressing and leaves huge uncertainty. The issue of having to repeatedly apply for medical cards and prove financial hardship can cause more significant distress for patients and their families. It is clear that the current system does not adequately address the unique financial needs of cancer patients, including those who require various treatments, medications and supportive care, such as prosthetics and wigs.

I propose we amend the legislation to enshrine clinically based eligibility on an equal footing with income. Cancer patients should automatically qualify and means testing should end. We should employ a streamlined cancer form and a digital submission pathway, and oncology teams should be allowed, if needed, pre-certify that applicants have a cancer diagnosis and are accessing treatment, just as we did for Ukrainian patients with a GP sign-off. We should guarantee active cards from day one of diagnosis that are valid until treatment concludes, without interruption, renewal or a retreatment application. Cancer patients are our friends, neighbours and families. They do not need bills; they need care. We can give them some certainty if we can deliver on this.

Niamh Smyth (Cavan-Monaghan, Fianna Fail)
Link to this: Individually | In context

I thank the Deputy for her heartfelt request and for raising this important issue. I welcome the opportunity to update the House on this matter on behalf of the Department of Health.

Under the Health Act 1970, eligibility for a medical card is based primarily on means. The Act obliges the HSE to assess whether a person is unable, without undue hardship, to arrange medical services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure. Persons aged 70 or older are assessed under medical card income thresholds, which are based on gross income. Persons aged 69 and under are assessed under the general means-tested medical card thresholds, which are based on the applicant's household income after tax and the reduction of PRSI and the universal social charge. Certain expenses are also taken into account.

In line with the legislation, the HSE is obliged to obtain relevant financial information and documents from applicants to facilitate due consideration of the assessable income and allowable expenses of individuals and families, and to assess these in order to determine their eligibility for a medical card. Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card. For example, emergency medical cards are issued to patients who are terminally ill, which the Deputy referred to, or are seriously ill and in urgent need of medical care they cannot afford. In these cases, a medical card is issued within 24 hours of receipt of the required patient details and completed medical form by a healthcare professional. These cards are not subject to a means assessment.

Applications for a medical card and a GP card can be made online. This is the quickest method of getting the card. All of the required documentation that will assist in an application can be uploaded online with the application. Alternatively, an application form can be downloaded from the HSE's website or applicants can contact the HSE to request a paper form because we appreciate not everybody can avail of digitalisation. We often see that, especially with older clients who come to our offices. The completed forms can then be returned to the HSE by email or post. HSE staff are also available by telephone to answer questions from people who want to chat to them about their personal applications. Furthermore, the HSE medical card and GP visit card national assessment guidelines are available on the HSE website to provide information and assistance to applicants in making their application. In doing so, the HSE strives to have an application process for medical cards that is as streamlined and straightforward as possible for all applicants.

According to the HSE, 189,391 medical card and GP visit card applications were processed between January and May of this year. Out of these, 175,151, or 92%, were approved at the first time of processing. Furthermore, 99% of all completed applications within the above timeframe are processed within 15 working days. However, if the HSE does not have all the information it needs, it will then contact the applicant to let him or her know what is missing. This can delay the processing of the application.

I will refer again to the Deputy's comments on cancer patients. I agree that those facing that very difficult journey do not need the burden of financial constraints. To answer that, and I am sure the Deputy is aware of this, an emergency medical card can be issued within 24 hours.

Erin McGreehan (Louth, Fianna Fail)
Link to this: Individually | In context

Absolutely. There have been huge improvements over the past couple of years. I will go back to the fact that people with cancer are recovering. We have more cancer survivors than ever before. That means they are leaving treatment, are healthy and are getting back to being economic actors who are delivering back to the State. I ask that when we look at cancer, we help patients with cancer through the cancer by not being financially burdened and having that hardship carry on into their recovery. The Minister of State rightly said, as I did, in regard to cancer patients, or people who are terminal, we should be looking after people to help them survive and live when they have cancer, as opposed to just looking after them when they are terminally ill.

Niamh Smyth (Cavan-Monaghan, Fianna Fail)
Link to this: Individually | In context

As I outlined, eligibility for the medical card is primarily based on means and a financial assessment conducted by the HSE in accordance with the Health Act 1970. The HSE has put in place a range of measures to assist people in applying for the medical card, which includes the availability of medical cards online. All of this the Deputy knows. I concur with the sentiment of her proposition that for cancer patients and those who are facing that journey, a much quicker, faster and easier process should be in place for them.