Frank Feighan (Sligo-Leitrim, Fine Gael) | Oireachtas source

I thank Senator Conway for his kind remarks. It is great to be back here in the Seanad. I am delighted to see Senator Wall here. I serve with his dad in the Oireachtas so it is great to see him back here as well.

Before addressing the medical card limits for the over-70s, which both Senators have raised today, it is important to acknowledge the difficult year that older persons in our society have experienced as a result of Covid-19. In particular, social distancing and cocooning were and remain challenging for many older persons. They continue, however, to show tremendous strength and resilience in helping to fight the spread of Covid-19.

Budget 2020 provided for an increase in the medical card thresholds for persons aged 70 and over. Although it was intended that this measure would be implemented from July, as Senator Conway stated, it was not possible to legislate for the necessary amendments to provide for this measure until there was a fully constituted Dáil and Seanad. It is welcome, therefore, that the Health (General Practitioner Service and Alteration of Criteria for Eligibility) Act 2020, which provides for the increase of the income thresholds, was passed by the Houses of the Oireachtas and subsequently enacted on 2 August 2020. However, relevant sections in this Act which provide for the increased income limits have not yet commenced, and this has undoubtedly been a source of frustration to those people aged 70 and over who may be eligible under the new thresholds.

While the delay is regrettable, it is important to understand that this budget 2020 commitment was contingent on the realisation of certain savings within the health budget. Those savings, however, could not be achieved this year due to the impact of the Covid-19 pandemic and a substantial allocation of additional funding to the health service to deal with this pandemic. It is in this context that decisions on the associated funding and implementation of the measures are being actively considered by Government. I will bring to the Minister the Senator's issue of the thousands of over-70s who have raised their concerns.

Turning to Senator Wall's query regarding reviews of eligibility, the HSE temporarily suspended all reviews of eligibility at the outset of the pandemic in March until last month. All cards that were due to expire during that period had their eligibility extended for up to one year and will be reassessed on a planning basis. This step demonstrates the practical and compassionate approach taken by the HSE during unprecedented times.

While periodic eligibility reviews have since resumed, it is important to recognise that the HSE operates a sensitive assessment process and may also exercise discretion and grant a medical card where individuals exceed the income guidelines but face other difficult circumstances such as extra costs arising from an illness.In the case of terminally-ill people, the HSE has a compassionate system in place for the provision of medical cards when it is informed a patient is receiving end-of-life treatment. This is where patients unfortunately have a prognosis of less than 12 months. These applications do not require a means assessment nor are they reassessed. However, not all terminally-ill patients may qualify for a medical card and this understandably causes upset and concern. To that end, the HSE clinical advisory group, CAG, was established in December 2019 to review this issue. The work of the CAG has now concluded. A report was submitted to the Department and is currently under investigation and consideration. Senator Wall outlined what a comfort blanket the card can be for terminally-ill people with 12 months or less to live and their families, which I fully accept. I will bring the issue to the Minister's attention.