Bernard Durkan (Kildare North, Fine Gael)
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250. To ask the Minister for Health the extent to which it might be possible to streamline and expedite the process of medical card applications; and if he will make a statement on the matter. [12412/17]

Bernard Durkan (Kildare North, Fine Gael)
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253. To ask the Minister for Health the extent to which procedures are in place to ensure that persons that do not qualify for medical cards on income grounds might be re-evaluated and their eligibility suitably weighted to take account of a particular illness, terminal or otherwise, which might require extraordinary care, cost, attention and stress to the particular families; and if he will make a statement on the matter. [12415/17]

Simon Harris (Wicklow, Fine Gael)
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I propose to take Questions Nos. 250 and 253 together.

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 dependents 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 dependents. 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 may face difficult financial circumstances, such as extra costs arising from illness.

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. As at week ending 3rd February 2017, 99% of medical card applications received by the Primary Care Reimbursement Services were processed within a 15 day timeframe.

All applications or reviews concerning medical and GP visit cards must be supported with a range of documentation, as outlined on the application forms. Where such supporting documentation is not supplied or is incomplete, to enable the assessment of the application, in accordance with the National Assessment Guidelines, the HSE will issue correspondence to the applicant specifying the additional information required to progress the assessment of their application. Clearly the processing time for incomplete applications is dependent on the furnishing of the required documentation by the applicant.

It is important that people with medical needs and it is important that they should be able to access necessary assistance in a straight forward manner. It is clear 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 117,854 as of 1st February this year. This followed the measures announced by my predecessor Minister Varadkar, when the "Keane" Report of the Expert Panel on Medical Need for Medical Card Eligibilitywas published. The "Keane" Report found that it is not feasible, desirable or ethically justifiable to list medical conditions for medical card eligibility. On foot of the publication of the 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. Its establishment followed the completion of the work of the Expert Panel on Medical Need for Medical Card Eligibility and demonstrates the HSE's commitment to the development of a medical system which is responsive and considerate of an applicant's particular circumstances.

The HSE has a system in place for the provision of medical cards in response to an emergency situation for persons with a serious medical condition in need of urgent or on-going medical care that they cannot afford and persons in palliative care, who are terminally ill. With the exception of terminally ill patients, all medical cards, granted on an emergency basis, are issued on the basis that the patient is eligible for a medical card on the basis of means or undue hardship, and will follow up with a full application within a number of weeks of receiving the medical card eligibility. These cards are issued within 24 hours of receipt of the required patient details and a letter which confirms the medical condition from a doctor or consultant. For terminally ill persons, no means test applies.