Mary Lou McDonald (Dublin Central, Sinn Fein)
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267. To ask the Minister for Health the projected annual saving to the Exchequer following his decision to withdraw the automatic entitlement to a medical card for patients undergoing treatment for cancer. [35812/13]

Róisín Shortall (Dublin North West, Independent)
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272. To ask the Minister for Health the changes that have been made to the criteria applying the way discretionary medical cards are awarded in the cases of persons with cancer. [35821/13]

Alex White (Dublin South, Labour)
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I propose to take Questions Nos. 267 and 272 together.

Under the provisions of the Health Act 1970, the assessment for a medical card is determined primarily by reference to the means, including the income and expenditure, of the applicant and his or her partner and dependants. There is no automatic entitlement to a medical card for persons with a specific illness, such as cancer, nor has the criteria applied to medical card applications by cancer patients been amended or reviewed.

However, under the legislation, there is provision for discretion by the HSE to grant a medical card where a person's income exceeds the income guidelines. The HSE takes a person's social and medical issues into account in determining whether or not "undue hardship" exists for a person in providing a health service for themselves or his or her dependents. The HSE has an effective system in place for the provision of emergency medical cards for patients who are terminally ill, or who are seriously ill and in urgent need of medical care that they cannot afford. They are issued within twenty-four hours of receipt of the required patient details and the letter of confirmation of the condition from a doctor or a medical consultant. With the exception of terminally ill patients, the HSE issues all emergency cards on the basis that the patient is eligible for a medical card on the basis of means or undue hardship, and that the applicant will follow up with a full application within a number of weeks of receiving the emergency card. As a result, emergency medical cards are issued to a named individual, with a limited eligibility period of six months.

For persons with a terminal illness, no means test applies. Once the terminal illness is verified, patients are given an emergency medical card for six months. Given the nature and urgency of the issue, the HSE has appropriate escalation routes to ensure that the person gets the card as quickly as possible.