Alex White (Dublin South, Labour) | Oireachtas source

I thank the Senator for raising the matter. As the Senator and the House will be aware, under the provisions of the Health Act 1970, assessment for a medical card is determined primarily by reference to the means, including the income and expenditure, of the applicant and his or her partner and dependants.

While people with specific illnesses such as cancer are not automatically entitled to medical cards, the legislation provides for discretion by the HSE to grant a medical card where a person's income exceeds the income guidelines. The HSE takes a person's social and medical issues into account when determining whether there is "undue hardship", the phrase used in the Act, for a person in providing a health service for himself, herself or his or her dependants.

The HSE has an effective system in place for the provision of emergency medical cardsfor patients who are terminally ill, or who are seriously ill and in urgent need of medical care that they cannot afford. For persons with a terminal illness,no means test applies. Emergency medical cards are issued within 24 hours of receipt of the required patient details and the letter of confirmation of the condition from a doctor or a medical consultant. Once the terminal illness is verified, patients are given an emergency medical card for six months. Given the nature and urgency of the issue, the HSE has appropriate escalation routes to ensure such people get their cards as quickly as possible.

With the exception of terminally ill patients, the HSE issues all emergency cards on the basis that the patient is eligible for a medical card arising from their means or undue hardship, and that the applicant will follow up with a full application within a number of weeks of receiving the emergency card. As a result, currently emergency medical cards are issued to a named individual with a limited eligibility period of six months. The HSE ensures that the system responds to the variety of circumstances and complexities faced by individuals in these circumstances.

The person referred to by the Senator was issued an emergency medical card in July 2012 for a period of one year. In March 2013 she was issued a renewal notice as she then became eligible for the over-70s scheme. Based on her declared income she qualified for a GP visit card, but her application was referred to the medical officer for consideration on medical discretionary grounds. The medical officer recommended that her full medical card be retained and remain valid until 31 January 2014. I am informed that at no stage was the person without medical card cover during this process.