James Bannon (Longford-Westmeath, Fine Gael)
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1301. To ask the Minister for Health the reason for the increase in the number of medical card refusals particularly in cases where applicants are seriously ill; the reason mortgages/home loans and so on are now not being taken into account when assessing applications; and if he will make a statement on the matter. [37012/13]

Alex White (Dublin South, Labour)
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Under the provisions of the Health Act 1970, medical cards are provided to persons who are, in the opinion of the Health Service Executive (HSE) unable without undue hardship to arrange GP services for themselves and their dependants. Assessment for a medical card is determined primarily by reference to the means, including the income and reasonable expenditure, of the applicant and his or her partner and dependants.

There is also provision for discretion by the HSE to grant a card in cases of "undue hardship" where the income guidelines are exceeded. Such cases are decided by a qualified Medical Officer. Medical expenses are taken into account when assessing an application on hardship grounds.

The HSE has produced national assessment guidelines to provide a clear framework to assist in the making of reasonable, consistent and equitable decisions when assessing an applicant for the General Medical Services scheme. These guidelines are publicly available and can be downloaded from the HSE's medical card website.

Budget 2013 announced that the rules on a person's expenses that are taken into account in calculating their net income for medical card purposes would be tightened.

Changes recently introduced by the Health Service Executive from April 2013 onwards mean that payments on a home improvement loan and a €50 per week allowance for a car are excluded from the standard means test assessment.

For clarity, the exclusion from travel to work costs relates to removing the weekly amount of €50 allowed to cover standing charges, such as depreciation or other running costs, used when considering travel to work costs as an outgoing where public transport is not available or suitable and a car is required. This means that the HSE will continue to consider the standard mileage costs or public transport costs when assessing eligibility.

The Deputy may be aware that there are a broad range of allowable expenses under the means test assessment for medical cards that have not been affected by these changes.

I would like to assure the Deputy that the changes were identified with a view to mitigating the impact on the assessment process, while also yielding savings. In so doing, the new assessment arrangements continue to fully take account of a person's mortgage or rental expenses. In addition, other allowable expenses were protected Budget 2013. And finally, the need to reduce the income limits for medical cards was avoided.