Aodhán Ó Ríordáin (Dublin North Central, Labour) | Oireachtas source

I thank the Senator for raising this issue. She will be aware that, in accordance with the Health Act 1970, as amended, full eligibility and a medical card is awarded where a person cannot arrange GP services for himself or herself and his or her family without undue hardship, having regard to his or her financial circumstances.

In the situation outlined by the Senator, it is possible for a student who has income of €164 or more to be assessed in his or her own right for a medical card and the medical card status of the parents is not a relevant factor. The Minister of State, Deputy Kathleen Lynch, has not been made aware of any instances where problems referenced by the Senator have arisen and she has not provided details of any individual case. Should the Senator wish to provide information concerning a specific applicant, the national medical card unit would be happy to undertake a review and revert directly.

Eligibility under the medical card scheme for persons aged 16 to 25 years is assessed by reference to the HSE's medical card and GP visit card national assessment guidelines which state that persons aged 16 to 25, who are dependent on medical cardholders, are eligible for a medical card. A 16 to 25 year old is classed as a dependant if he or she is living with parents or a guardian or living away from home attending school or college and has no income or a weekly income less than €164. Where an applicant in this age bracket is earning more than €164 per week, then he or she is assessed as being financially independent. The figure of €164 is the current medical card income guideline for a single person living with family.

Where deemed appropriate, the HSE may exercise discretion and grant a medical card where an applicant exceeds the income guidelines but where he or she faces difficult financial circumstances, for example, costs arising from an illness. The HSE affords applicants the opportunity to furnish supporting information and documentation to fully take account of all the relevant circumstances that may benefit them in the assessment, including medical evidence of cost and necessary expenses. Greater discretion is being exercised by the HSE as is evidenced by the number of discretionary medical cards in circulation, which has increased from approximately 52,000 in mid-2014 to nearly 96,000 on 1 November this year.

On foot of the Keane report, published last year, the HSE established a clinical advisory group to develop clinical oversight and guidance for the operation of a more compassionate and trusted medical card system. The group is continuing its work on the development of guidance on assessing medical card applications involving significant medical conditions. I hope this clarifies the matter for the Senator and reassures her that the HSE endeavours to operate in a fair manner within its legislative framework.