Finian McGrath (Dublin North Central, Independent)
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370. To ask the Minister for Health his views on making medical cards assessable for all children with a disability without having to go through the entire application process, which is stressful and discriminatory toward families and towards children with an intellectual disability; and if he will make a statement on the matter. [40081/15]

Kathleen Lynch (Cork North Central, Labour)
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As the Deputy will be aware, in accordance with the provisions of the Health Act 1970 (as amended), 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. The legislation obliges the HSE, when making a decision on a person’s eligibility, to take account of the person’s financial situation. This requires the provision of information including the income and reasonable expenditure, of the applicant and his/her partner and dependants and allows the HSE to assess each application in an equitable and consistent manner. In the case of a child, the parents' income and reasonable expenditure is assessed.

Where an applicant's means are above the financial thresholds as set out in the national guidelines, the HSE routinely examines for indications of medical or social circumstances which might result in undue financial hardship in arranging medical services and, exercising discretion, may grant eligibility for a medical card on this basis. The HSE affords applicants the opportunity to furnish additional 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.

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 nearly 96,000 at the beginning of November this year. This followed the measures announced by Minister Varadkar and I last year to improve the performance of the medical card system 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.

As part of the measures, the HSE is ensuring a more integrated and sensitive processing of medical card applications, involving greater exchange of information between the central assessment office and the local health offices in relation to people’s medical circumstances and needs. Where a person does not qualify for a medical card, they may be provided with a GP Visit Card, appropriate therapy or other community supports or drugs and appliances under the Long Term Illness scheme, where the qualification criteria are met.

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. The CAG is continuing its work on developing a framework for assessment and measurement of the burden of disease and appropriate operational guidelines for the medical card scheme and to consider and advise in relation to a more compassionate and supportive approach to include an assessment of the burden of a medical condition(s) in decisions on medical cards.