Alex White (Dublin South, Labour) | Oireachtas source

I should clarify that, under the relevant legislation, determination of an individual's eligibility for a medical card is the statutory responsibility of the HSE. It is very clear, under that legislation, that there is no role for the Minister for Health in assessing medical card eligibility. Furthermore, under the Health Act 2004, as amended, the Minister for Health may not give a direction to the HSE relating to a decision concerning the eligibility of an individual. As a result of her assiduous work in this area, I know Senator Moloney is aware of the PCRS contact service for Members of the Oireachtas so I will not read the part of the script relating to it.
In the context of the person in County Kerry to whom this matter relates, I do not believe it would be appropriate to discuss an individual's financial or medical circumstances in public in the Seanad. However, I can advise the Senator and the House of recent developments with regard to medical card eligibility, including with respect to discretionary cards. The Government has decided to formulate a new policy whereby eligibility for health services can take account of medical conditions, in addition to the existing basis of financial means. The HSE has established an expert panel to examine the range of conditions that should be considered as part of this process and has been asked to submit a report by September. The expert panel, which is chaired by Professor Frank Keane, past president of the Royal College of Surgeons in Ireland and clinical lead of the national clinical programme for surgery, includes a range of 23 clinical experts from primary care, specialist services and therapies. In addition, the HSE has put in place a public consultation process to facilitate the public, patients, representative groups and professional bodies to feed into this process. I understand that more than 2,800 individual submissions have been received at this point. The HSE will also arrange a consultative forum of representative patient groups to support and enable them to feed into the process in a structured fashion. In the context of this policy development, the HSE suspended reviews - including appeals - of medical cards where discretion had been exercised to take account of medical circumstances, pending the outcome of this process. The HSE has extended the eligibility of the individuals concerned.
Whereas I am not in a position to discuss the specifics of the case to which the Senator refers, I can inform her that if the medical card of the individual concerned was under review in circumstances where discretion had been exercised, it is difficult to understand why his card was not covered by the decision to suspend reviews. That is, of course, if the person concerned falls into the relevant category.
The Government was concerned that a number of people with serious medical conditions had been refused the renewal of their discretionary medical cards since the centralisation of assessment was completed in mid-2011. Therefore, it has decided that medical cards or GP visit cards are to be issued to persons with serious medical conditions or disabilities who had the renewal of their discretionary card refused by the HSE, having completed an eligibility review during the period from 1 July 2011 to 31 May 2014. That does not seem to cover the individual to whom Senator Moloney refers. The HSE has been working assiduously to issue cards to the estimated 15,000 persons whose reviews were completed between 1 July 2011 and 31 May 2014. It had already issued 4,151 discretionary cards by the end of last week. This priority should see all those qualifying issued with cards by mid-July. Those who wish to obtain further information can contact the HSE via the relevant LoCall number.
It is also recognised that a small number of individuals may not have been able to have been reviewed during the defined period, whether due to circumstances relating to their medical condition, hospitalisation during treatment, change of residence during treatment, etc. As a result, the director general of the HSE may act, on his own initiative, to take account of an ad misericordiamappeal on a case by case basis to issue a discretionary card to such a person who has a serious medical condition. I take this opportunity to point out that regular probity reviews in relation to those who qualify for medical and GP cards on financial grounds. The provisions of the Act have not changed in that regard.
If the individual to whom Senator Moloney refers falls into the category of people whose reviews were in train when the Government's decision was announced, then he should be able to benefit from the suspension of the review process. That is all I can say in respect of this case. I will, however, undertake to ensure that the Senator obtains a response to the query she raised with the PCRS.