Tommy Broughan (Dublin North East, Labour)
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482. To ask the Minister for Health the reason all amputee citizens do not have discretionary medical cards in view of the need to change costly prosthetic limbs regularly, including up to three or four times per annum for children and teenagers. [52613/13]

James Reilly (Dublin North, Fine Gael)
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Under the provisions of the Health Act 1970 (as amended), eligibility for health services in Ireland is based primarily on residency and means. The Act provides that persons who are unable without undue hardship to arrange GP services for themselves and family qualify for a medical card. The HSE can only award medical cards in accordance with the Act and, therefore, it must assess applicants on the overall financial situation of the applicant and his or her dependants. The HSE gives effect to this legislation through its Medical Card National Assessment Guidelines.

While there is no legal basis for the HSE to award medical cards on the basis of a specific medical condition, the HSE has, however, discretion to grant a medical card in certain circumstances. If an applicant’s means are above the financial thresholds, set out in the national guidelines, the HSE examines for any indication of circumstances (medical or social), which might result in undue financial hardship in the arranging of medical services. Eligibility may be granted on a discretionary basis if these circumstances are such that a person cannot arrange GP services for themselves and their family without undue financial hardship.

The HSE has a clinical panel which assists in the processing of applications for discretionary medical cards where there is financial expenditure related to a medical condition. This ensures that the applications by those diagnosed with an ailment are assessed and addressed in the most expeditious and sensitive way and that the specific situation of a person can be considered on a case-by-case basis.