Alex White (Dublin South, Labour) | Oireachtas source

No, absolutely not, on the contrary. In respect of medical cards extended on a discretionary basis, social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. This applies even where the person is above the income guidelines and the person can apply to be dealt with under the discretion which is available to be exercised. That discretion is applied automatically during the processing of the application where additional information has been provided which can be considered by staff or a medical officer, where appropriate.

At the request of the Minister for Health, Deputy James Reilly, the HSE has set up a clinical panel to assist in the processing of applications for a discretionary medical card where a person exceeds income guidelines but where there are difficult personal circumstances such as an illness.

The community medical officer reviews and interprets medical information provided by the applicant on a confidential basis. He or she then liaises with general practitioners, hospital consultants and other health professionals, as appropriate, to determine the health needs of the applicant and his or her family and dependants. The community medical officer then applies discretion within the guidelines to determine if the applicant is suffering from medical hardship. It is important to stress the medical card system is founded on the undue hardship test. The Health Act 1970 provides for medical cards on the basis of means. As I have indicated, this is what the law states and no Minister can go outside the legal parameters that are set out. One could best describe the discretionary system as being an exception to the general rule that one must satisfy the income limits.

The Health Service Executive, HSE, also has a system in place for the provision of emergency medical cards for patients who are terminally ill or who are seriously ill and in urgent need of medical care they cannot afford. Emergency medical cards are issued within 24 hours of receipt of the required patient details. With the exception of terminally ill patients in palliative care, all emergency cards are issued for six months on the basis that the patient is eligible for a medical card on the basis of means or undue hardship and will follow up with a full application within a number of weeks of receiving the emergency card. Where a patient is terminally ill in palliative care, the nature of the terminal illness is not a deciding factor in the issue of an emergency medical card in these circumstances and no means test applies. Given the nature and urgency of the issue, the HSE has appropriate escalation routes to ensure the person gets the card as quickly as possible.