Mattie McGrath (Tipperary South, Independent)
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Question 538: To ask the Minister for Health his views that a public health nurse refused to treat a public patient because the patient does not hold a medical card (details supplied); his further views that this constitutes a three tier system that is private patients, public patients with a medical card and public patients without a medical card; the options available to this patient to ensure that the proper aftercare is administered when this patient is not in a position to afford daily GP or nurse visits as required due to the current economic circumstances; and if he will make a statement on the matter. [32335/11]

Róisín Shortall (Dublin North West, Labour)
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At present almost 40% of the population are covered by the General Medical Services (GMS) Scheme. Any person who is experiencing undue hardship in paying for a medical service may apply to the HSE for a medical card or a GP visit card. The HSE, in assessing a person's means, takes into account expenditure by the applicant on medical services and medication.

If the individual in question is experiencing undue hardship in paying for this particular service, it is open to her to submit an application to the HSE for consideration on a discretionary basis. The Government is embarking on a major reform programme for the health system. The aim is to deliver a single-tier health service, supported by universal health insurance, which will ensure equal access to care based on need, not income. A fundamental element in the reform process involves significant strengthening of primary care services to deliver universal primary care with the removal of cost as a barrier to access for patients. The phased implementation programme will be overseen by both the Minister for Health and myself, as Minister of State for Primary Care.