Sandra McLellan (Cork East, Sinn Fein)
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245. To ask the Minister for Health the reasons persons who have life threatening serious illnesses are not granted a medical card for life (details supplied). [41239/13]

Alex White (Dublin South, Labour)
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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. While people with specific illnesses are not automatically entitled to medical cards, the legislation provides for discretion by the HSE to grant a medical card where a person's income exceeds the income guidelines. In these cases, social and medical issues are considered when determining whether or not undue hardship exists for the individual in accessing GP or other medical services. Discretion will be applied automatically during the processing of an application where additional information has been provided which can be considered with discretion by staff or a medical officer, where appropriate. At Minister Reilly's request, the HSE set up a clinical panel to assist in the processing of applications for discretionary medical cards, where a person exceeds the income guidelines but there are difficult personal circumstances, such as an illness.

The HSE also has a system in place in relation to 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. Emergency medical cards are issued within 24 hours of receipt of the required patient details and letter of confirmation of condition from a doctor or consultant and are generally requested by a manager in a Local Health Office or a Social Worker.

With the exception of terminally ill patients in palliative care, all emergency cards are issued for six months on the basis that the patient is eligible for a medical card on the basis of means or undue hardship, and will follow up with a full application within a number of weeks of receiving the emergency card. Where a patient is terminally ill in palliative care, the nature of the terminal illness is not a deciding factor in the issue of an emergency medical card in these circumstances and no means test applies.

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 and the HSE ensures that the system responds to the variety of circumstances and complexities faced by individuals in these circumstances. The HSE has been asked to examine this individual matter raised by the Deputy and to respond as soon as possible.