Mary Mitchell O'Connor (Dún Laoghaire, Fine Gael)
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397. To ask the Minister for Health the reason there are still cases of persons, and especially young children, being refused discretionary medical cards, despite being extremely ill and in view of the Health Service Executive stating in November 2014, that the process would be enhanced to make it more sensitive to people’s needs; and if he will make a statement on the matter. [3785/15]

Kathleen Lynch (Cork North Central, Labour)
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As the Deputy will be aware, eligibility for medical cards is set out in the Health Act 1970 (as amended). The Act provides that persons, unable without undue hardship having regard to their overall financial situation to arrange GP services for themselves and family, qualify for a medical card. The Deputy will also be aware of the publication of the Report of the Expert Panel on Medical Need for Medical Card Eligibilityand the Medical Card Process Reviewin November 2014. A key recommendation of the Expert Panel was that a person’s means should remain the main qualifier for a medical card.

The HSE has discretion, exercised in accordance with the legislation, to grant a medical card where a person's income exceeds the income guidelines. The HSE is obliged to operate within the legal parameters as set out in the Health Act, while also responding to the variety of circumstances and complexities faced by individuals who apply for a medical card.

In the light of the conclusions of the two reports a range of actions have been identified to improve the operation of the medical card system, particularly for people with significant medical needs. The HSE has appointed a senior manager to lead the reform of the systems for handling medical card application and reviews. Under one of the actions, the HSE is taking steps to establish a clinical advisory group to develop a methodology and guidance for the assessment of applications involving significant medical conditions so as to take account of the burden involved and the needs arising from the condition and to ensure that appropriate services are provided to people who need them. The HSE is also putting arrangements in place for a more integrated and sensitive processing of medical card applications involving significant medical conditions to ensure greater interaction between the central office regarding the assessment of a person’s eligibility and the local health office regarding the person’s medical condition and the services that they may require. Consequently, the number of medical cards issued, where the HSE has exercised discretion, has increased from approximately 50,300 at the start of 2014 to approximately 76,700 at the start of 2015.

The Minister and I have also asked the HSE to examine, with the Department of Health, the best way to meet the needs of people with significant medical conditions who need the support of the public health system. This work includes considering the best way to make medical aids and appliances available to persons who do not hold a medical card, the provision of services to children with severe disabilities, and to enable people with particular needs to have these met on an individual basis rather than awarding a medical card to all family members.