James Reilly (Dublin North, Fine Gael) | Oireachtas source

More than 1.8 million medical cards have been issued to individuals, the highest number in the history of the State. It represents an increase of approximately 500,000 since the end of 2008. It is expected that the provision of GP services and prescription drugs under the general medical services scheme will cost almost ¤2 billion in 2012. We have already issued a further 35,000 medical cards this year than we had budgeted for.

Under the provisions of the Health Act 1970, medical cards are provided for persons who, in the opinion of the Health Service Executive, are unable without undue hardship to arrange GP services for themselves and their dependants. Under the legislation, determination of eligibility for a medical card is the responsibility of the HSE. The assessment for a medical card is determined primarily by reference to the means, including income and reasonable expenditure, of the applicant and his or her partner and dependants. The HSE has produced national assessment guidelines to provide a clear framework to assist in the making of reasonable, consistent and equitable decisions when assessing an applicant under the general medical services scheme. The guidelines are publicly available and can be downloaded from the HSE's medical card website.

There is no automatic entitlement under the 1970 Act to a medical card on the basis of a specific illness. However, there is provision for discretion for the HSE to grant a medical card in cases of undue hardship where the income guidelines are exceeded. The HSE has set up a clinical panel to assist in the processing of applications for discretionary medical cards where there are difficult personal circumstances. It has also established a specific system for the provision of emergency medical cards for patients who are terminally or seriously ill and in urgent need of medical care which they cannot afford. These emergency medical cards are issued within 24 hours of receipt of the required patient details and a letter of confirmation of the condition from a doctor or medical consultant. This system is initiated through the local health office by the office manager.

Every year the HSE processes in excess of 500,000 applications for medical cards and GP visit cards. It centralised the processing of all medical card applications and renewals at the its primary care reimbursement service with effect from 1 July 2011. This established a single uniform system of assessment for all applicants to replace the various systems which previously operated through more than 100 local offices across the country. I am aware that difficulties with the centralisation project gave rise to a large backlog and long delays for both new applicants and those seeking medical card renewals earlier this year. However, the HSE has taken a range of actions which completely eliminated the backlog of almost 58,000 applications from earlier this year and confirmed that over 95% of complete medical card applications and renewal forms are now being processed within 15 working days. It has also implemented a range of changes to the application procedures which have improved the process for applicants.