Terence Flanagan (Dublin North East, Renua Ireland)
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813. To ask the Minister for Health to deal with a matter (details attached) regarding medical cards; and if he will make a statement on the matter. [38122/15]

Kathleen Lynch (Cork North Central, Labour)
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Under the Health Act, 1970, medical cards are provided to persons who are, in the opinion of the HSE, unable without undue hardship to arrange GP services for themselves and their dependants and every application must be assessed on that basis. In accordance with the Act, 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. Where deemed appropriate in particular circumstances, the HSE may exercise discretion and grant a medical card even though an applicant exceeds the income guidelines but where they who face difficult financial circumstances, such as extra costs arising from an illness.

It is clear that there are people with medical needs and it is important that they should be able to access necessary assistance in a straight forward manner. Greater discretion is being exercised by the HSE because the number of discretionary medical cards in circulation has increased from about 52,000 in mid-2014 to over 94,000 at the beginning of October this year. This followed the measures announced by Minister Varadkar and I last year, when the "Keane" Report of the Expert Panel on Medical Need for Medical Card Eligibility was published. The Deputy may be aware that a key recommendation of that report was that a person’s means should remain the main qualifier for a medical card. It also recommended that it is neither feasible nor desirable to list conditions in priority order for medical card eligibility.

Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. Social and medical issues are considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services. The HSE affords applicants the opportunity to furnish supporting information and documentation to fully take account of all the relevant circumstances that may benefit them in the assessment, including medical evidence of cost and necessary expenses.

On foot of the Keane Report, the HSE established a Clinical Advisory Group to develop clinical oversight and guidance for the operation of a more compassionate and trusted medical card system. The Director General of the HSE accepted an interim recommendation of the Group to award medical card eligibility to all children under 18 years of age with a diagnosis of cancer, effective from 1 July 2015. Any child not 18 and who has had a diagnosis of cancer within the preceding 5 years ending 30 June 2015 may be awarded a medical card under the terms of this decision for such period, not to exceed five years, as seems appropriate in the individual circumstances. The Group is continuing its work on the development of guidance on assessing medical card applications involving significant medical conditions.

We do not have a universal eligibility system for primary and community health services. Until we have universal health care and everyone is entitled to health care, one will always have anomalies and injustices. There will always be somebody who is just above the means threshold, or who does not have the prescribed disease, or whose condition is not sufficiently severe and, as a result, these individuals will not meet the assessment criteria.