Thursday, 24 January 2019
Nithe i dtosach suíonna - Commencement Matters
Medical Card Appeals
I thank the Cathaoirleach and Senator Byrne. I am taking this matter on behalf of the Minister, Deputy Harris.As the Senator will be aware, eligibility for a medical card is determined by the HSE in accordance with the provisions of the Health Act 1970, as amended. Applicants must complete and submit a medical card application form to the Health Service Executive national medical card unit for assessment.
Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for medical cards and, in particular, to take full account of the difficult circumstances in the cases of applicants who may be in excess of the income guidelines. The national medical card unit receives approximately 39,000 medical and GP visit card applications per month. A large percentage of these applications will be deemed unsuccessful for reasons such as insufficient information provided or failing to meet the qualifying criteria. Where a person is unhappy with a decision concerning entitlement to a medical card, he or she has the right of appeal to the HSE appeals officer. The HSE's national appeals office plays an important role in ensuring procedures, guidelines and legislation are correctly and fairly followed. The appeals officer will review the original decision and make an independent decision, taking into consideration relevant legislation and guidelines. In particular, the appeals officer considers if income and expenses have been appropriately assessed and if the applicant is in a category of people who are exempt from the financial means assessment.
Community healthcare organisation, CHO, 3 region covers Clare, Limerick and north Tipperary with a population of almost 400,000 people. In 2018, only 25 medical card appeals from the CHO 3 region were submitted to the HSE’s national appeals office. In these cases, the independent and impartial appeals officer reviewed the original decision made, and ultimately deemed the 25 applications to be subsequently eligible for a medical card. This demonstrates the important role of an appeals mechanism, ensuring that good governance, impartiality and due regard are given to the nature of decisions related to medical card eligibility.
The HSE also recognises the importance of having a compassionate and holistic process in the assessment of medical card applications. To this end, a number of measures have been implemented, including the development of a burden of illness questionnaire. This questionnaire is now being rolled out in circumstances where the assessing doctor in the HSE's national medical card unit requires a more comprehensive assessment of an applicant's medical and social circumstances and any resulting undue financial hardship.
I hope this clarifies the matter for Senator Byrne and reassures her that the medical card appeals process is operated in a fair, impartial and efficient manner and within its legislative framework. I have listened to what the Senator said and if there is any way that I or the Minister's office can help in dealing with some of the cases she has raised, particularly those involving people who are terminally ill or fighting an illness and dealing with the emotions and everything else that goes with having a severe illness, we will do so. If she provides details, I will certainly bring the cases to the attention of the relevant authority.