Michael Healy-Rae (Kerry South, Independent)
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405. To ask the Minister for Health his views on correspondence (details supplied) regarding the parents of children in receipt of the domiciliary care allowance, his plans to address the concerns raised; and if he will make a statement on the matter. [44916/15]

Terence Flanagan (Dublin North East, Renua Ireland)
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486. To ask the Minister for Health if he will introduce medical cards for all children in receipt of a domiciliary care allowance (details supplied); and if he will make a statement on the matter. [45452/15]

Kathleen Lynch (Cork North Central, Labour)
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I propose to take Questions Nos. 405 and 486 together.

Under the provisions of the Health Acts, 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. In the assessment process, the HSE can take into account medical costs incurred by an individual or a family. Where deemed appropriate in particular circumstances, the HSE may exercise discretion and grant a medical card even though an applicant's means exceed the prescribed threshold. 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.

The Domiciliary Care Allowance (DCA) payment is made by the Minister for Social Protection to carers in respect of a child at home under 16 years of age with a severe disability, where it has been determined that the child requires ongoing care and attention, substantially over and above the care and attention usually required by a child of the same age. Eligibility for the DCA is not based primarily on the medical or psychological condition, but on the resulting lack of function of body or mind necessitating the degree of extra care and attention required. As such it is not possible to say if a particular child or any particular medical condition or disability will qualify for a payment under the DCA scheme.

The Deputy will be aware that the report of the Expert Panel on Medical Need for Medical Card Eligibility, known as the Keane Report, recommended that a person’s means should remain the main qualifier for a medical card and that it was not feasible, desirable, nor ethically justifiable to list medical conditions for medical card eligibility. Nonetheless, it is clear that there are people – including children - with medical needs and it is important that they should be able to access necessary assistance in a straight forward manner.

Consequently, the Clinical Advisory Group on medical card eligibility was established by the HSE to develop a framework for assessment and measurement of the burden of disease and appropriate operational guidelines for the medical card scheme. However, the Clinical Advisory Group has not recommended that children in receipt of the Domiciliary Care Allowance should automatically qualify for a medical card. In advance of the Group completing its work, there are no proposals to issue automatic medical cards to one particular group.

The Government is committed to making the medical card system as responsive as possible to the circumstances of people with significant medical needs. As a result of a range of improvements, the HSE is exercising greater discretion. Consequently, the number of discretionary medical cards has increased by about 84% - from about 52,000 in mid-2014 to nearly 96,000 at the beginning of November this year.

Ultimately, the proper way to address this issue is to develop a system of universal health care, which is at the centre of Government health policy. Otherwise, whenever there are qualifying rules, there will always be a person who is above the means test, does not have the selected disease, or is not in receipt of the specific social welfare payment.