Paddy Burke (Fine Gael)
Link to this: Individually | In context | Oireachtas source

I welcome the Minister of State, Deputy Ó Ríordáin.

Marie Moloney (Labour)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State, Deputy Ó Ríordáin, for coming to the Chamber to take this matter on behalf of the Minister for Health. I will keep this short and sweet. I have been working in politics for more than 25 years and have dealt extensively with people applying for medical cards while helping them with their applications. I have never come across a case in which a full-time student did not receive a medical card in the same way as his or her parents. In this case, which I encountered recently, the mother is an invalid and the father is a carer. The student in question works during the summer and at weekends to help finance her way through college because her parents cannot afford to help her. However, due to her income from this work, she has been disallowed from getting a full medical card as held by her parents and she has only been given a GP visit card. I have no problem with eligibility being based on a student's income, provided this is applied across the board and all students are assessed on their income and means. This means in the case of parents who do not have medical cards because of their income, a student who has part-time earnings should be so assessed and it should be across the board. What if the girl in question happens to get sick and ends up in hospital? This is not beyond the bounds of possibility and could happen because while in college, my own daughter contracted glandular fever and ended up in hospital on a drip for nearly eight days. In such a scenario, this girl would not be able to afford €750 for hospital expenses because her parents certainly cannot afford it. I reiterate it is fair enough if this applies across the board but one cannot pick and choose whereby some students are assessed on their means while others are assessed on those of their parents.I wish to know when the criteria were changed because I did not hear about it and I am sure many other Members have not heard about it. One cannot get a straight answer from the primary care reimbursement service, PCRS. Its answer is, "That is the way it is". The reason I tabled this Commencement matter is in the hope that the Minister of State will tell me what is going on in the PCRS.

Aodhán Ó Ríordáin (Dublin North Central, Labour)
Link to this: Individually | In context | 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.

Marie Moloney (Labour)
Link to this: Individually | In context | Oireachtas source

The reason I did not supply the details is because I am talking about a policy rather than an individual but I will supply the details to the Minister of State to show that what I outlined has happened. According to the reply, the Minister of State said any student with an income of €164 in his or her own right will be assessed on his or her own means. Is that correct? Does that mean any student whose parents do not have medical cards but where he or she is working part-time and earning €164 will be assessed on his or her own merits? I wish to clarify that point.

Aodhán Ó Ríordáin (Dublin North Central, Labour)
Link to this: Individually | In context | Oireachtas source

Yes.

Marie Moloney (Labour)
Link to this: Individually | In context | Oireachtas source

That is grand. Basically, what we are saying to students is that they are far better off to earn their own income and to get more than €164 a week and they will get a medical card even if their parents are not entitled to one. I wish to clarify that the change was made across the board and that the PCRS was not picking and choosing who to assess and who not to assess. I will supply the Minister of State, Deputy Kathleen Lynch, with the details to show that it is happening as she does not appear to be aware that is the case.