Anne Rabbitte (Galway East, Fianna Fail) | Oireachtas source

I thank Senator O'Loughlin for raising this matter. She has quite rightly referred to John Wall in her speech. It is some 12 months since we were in the audio visual room in Leinster House when Mr. Wall made a presentation to Members. Brian Lynch from Gort, in my constituency, was also there on the day. At that point the situation with self-employed people was part of one of the issues. When we talk of means testing we also must look at those people who are self employed, which was part of the campaign. It is an important issue that has been the centre of much commentary and debate recently, namely, the ability of terminally ill patients to have access to a medical card.

At the outset, it is important to provide clarity for our patients and to reassure them that the process provides for a person who has a terminal illness to be eligible for a medical card, and that it is possible through a number of ways.

Where the HSE is informed that a patient is receiving end-of-life treatment, which is when the patient unfortunately has a prognosis of less than 12 months, a medical card is awarded to these patients. These patients are not required to undergo a financial needs assessment, nor are they ever reassessed. There are currently almost 1,800 medical cards granted under end-of-life criteria.

Terminally ill patients who do not meet the end-of-life criteria may also qualify for a medical card under the general assessment process, or they may initially be granted a medical card on an emergency basis for up to six months. I understand that not all persons with a terminal diagnosis will necessarily meet the end-of-life criteria when initially applying for a medical card, due to the staging or severity of their illness. I also appreciate and understand that this is a source of upset and concern to those patients. This is why the programme for Government provided a commitment to extend access to medical cards to persons who are terminally ill. A key part of the process to deliver on this commitment was the establishment of the HSE clinical advisory group in December 2019 to review the issue. The work of that group has concluded and on behalf of the Minister, Deputy Donnelly, I would like to publicly thank the clinical advisory group for the work it undertook to examine and review the many complexities that arise from this issue.

The report of the clinical advisory group was submitted to the Department in September and it was carefully considered. The report highlighted the practical and legal challenges with extending eligibility for medical cards to terminally ill patients within the framework of the current process. Nonetheless, this Government is committed delivering on this issue and therefore I am pleased to confirm that a detailed memo on the findings of the report and next steps was considered by Government this morning. The Minster is eager to move ahead on this matter and has requested that an ambitious work programme be immediately undertaken by officials that will ensure delivery on the programme for Government commitment. The Minister, Deputy Donnelly, has confirmed that the report of the clinical advisory group will be published imminently.

Finally, I wish to reassure patients that the Government is committed to ensuring that terminally ill patients have access to services they require, especially when their health needs are greatest.