Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I would like to thank the Senator for raising this important issue.

Under the Health Act 1970, as amended, eligibility for health services is based primarily on residency and means. The Senator will be aware of the publication of the report of the expert panel on medical need for medical card eligibility, and the medical card process review in November 2014. A key recommendation of the expert panel was that a means test should remain the main qualifier for a medical card. The panel concluded that it would not feasible, desirable, ethical or just to list medical conditions in order of priority as a means of determining medical card eligibility.

Discretion continues to be an integral part of the medical card assessment process. If an applicant's means are above the financial thresholds as set out in the national guidelines, the HSE routinely examines for indications of medical or social circumstances which might result in undue financial hardship in arranging medical services and, exercising discretion, may grant eligibility for a medical card on that basis.

The Senator will no doubt be aware that the temporary reinstatement of discretionary medical cards has been extended and holders of discretionary medical cards, including the terminally ill, are no longer included in random reviews. The Senator may be interested to know that the number of discretionary medical cards in circulation has increased from about 50,000 to 75,000, in part due to the reforms announced by the Minister of State, Deputy Kathleen Lynch, and I last year, although the implementation of the ten actions remains a work in progress.

I am aware that the HSE has developed more integrated and sensitive processing of applications, involving greater exchange of information between the central assessment office and the local health offices in relation to people's medical circumstances and needs.

I can also advise the Senator that the HSE currently funds a range of community services and supports to persons with Huntington's disease. The HSE's role is to apply a multi-disciplinary team approach which includes the provision of health and personal supports and incorporates hospital and primary care and community services. In this context, people with Huntington's disease receive interventions from a wide range of services and facilities, either directly from the HSE or through a range of voluntary service providers. One such voluntary service provider is the Huntington's Disease Association of Ireland, which works in partnership with the HSE to ensure that all of the resources available for people with disabilities are used in the most effective manner possible.

The HSE provides assisted living services, including personal assistant services, and therapeutic assistance, including physiotherapy, occupational therapy and speech and language therapy, as well as a range of medical interventions. People with Huntington's disease may be eligible for assistive devices such as medical or surgical aids and appliances that facilitate or maintain mobility or functional independence, and assessments are carried out by a range of multidisciplinary staff.