Finian McGrath (Dublin North Central, Independent)
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1098. To ask the Minister for Health his views on correspondence (details supplied) regarding income limits for the over 70's medical cards. [46154/13]

Alex White (Dublin South, Labour)
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The Government recognises that the living costs of an individual living alone are more than half the living costs of a couple living together and this is reflected, inter alia, through the provision of the Living Alone Increase and differential income limits for medical cards for persons aged under 70 years between individuals and couples.

In that context, the over-70s income limit for a single person has been reduced proportionately less than the income limit for a couple.

Finian McGrath (Dublin North Central, Independent)
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1099. To ask the Minister for Health if he will support medical cards for all children who are dying or children with severe disabilities as a matter of priority. [46155/13]

John Paul Phelan (Carlow-Kilkenny, Fine Gael)
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1152. To ask the Minister for Health if consideration has been given to granting full medical cards to all seriously ill children aged 18 and under; and if he will make a statement on the matter. [46429/13]

Alex White (Dublin South, Labour)
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I propose to take Questions Nos. 1099 and 1152 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 or disability.

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 in palliative care, 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 in palliative care, 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 in palliative care, 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.

The Government is committed to introducing, on a phased basis, a universal GP service without fees within its term of office, as set out in the Programme for Government and the Future Health strategy framework. As announced in the Budget, it has been decided to commence the roll-out of a universal GP service by providing all children aged 5 and under with access to a GP service without fees. This will mean that almost half of the population will have access to GP services without fees. The Government is providing new, additional funding of €37 million to meet the cost of this measure.

The implementation of this measure will require primary legislation. The necessary administrative arrangements will be made during the course of 2014, when the specifics of the legislation are known.

The introduction of a universal GP service constitutes a fundamental element in the Government's health reform programme. The current Government is the first in the history of the State to have committed itself to implementing a universal GP service for the entire population. A well functioning health system should provide equal access to health care for its patients on the basis of health needs, rather than ability to pay. The principles of universality and equity of access mean that all residents in Ireland should be entitled to access a GP services that is free at the point of use.