Billy Kelleher (Cork North Central, Fianna Fail)
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761. To ask the Minister for Health the number of discretionary medical cards he expects there to be in 2014; the reason the 2014 Health Service Executive Service Plan did not provide such information unlike previous service plans; and if he will make a statement on the matter. [55370/13]

Alex White (Dublin South, Labour)
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The 1970 Health Act provides that persons who are unable, without undue hardship, to arrange GP services for themselves and family qualify for a medical card, having regard to the overall financial situation of the applicant and his/her dependants.

Applications are, in the first instance, subject to a means assessment to determine if assessable income declared is within the set income limits to qualify for a medical card or a GP visit card. Medical card and GP visit card applications are considered in accordance with the Medical Card and GP Visit Card National Assessment Guidelines and where applicable, may be assessed on discretionary grounds and this assessment is based on the merits of each application.

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. Eligibility may be granted on a discretionary basis if these circumstances are such that a person cannot access General Practitioner or other medical services, without undue financial hardship. There can be a significant crossover between social and medical circumstances and applications do not fall discretely into these specific categories. The process where the application of discretion may be considered includes a review by HSE Medical Officers led by a Principal Medical Officer.

There is no such entity as a discretionary medical card and it is important to clarify that there is only one medical card. Again, a medical card is either approved on foot of a means assessment, which meet the current financial guidelines, or where the means test does not meet the guidelines and the HSE, having considered all of the circumstances, has applied discretion and granted a medical card because the family cannot access General Practitioner and other medical services without undue financial hardship.