Bernard Durkan (Kildare North, Fine Gael)
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463. To ask the Minister for Health if an examination has been carried out to review the medical card guidelines for persons with spinal injuries who want to work but see the potential loss of the medical card as a significant disincentive to taking up employment; and if he will make a statement on the matter. [42328/19]

Simon Harris (Wicklow, Fine Gael)
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Under the provisions of the Health Act 1970 (as amended), eligibility for health services in Ireland is based primarily on residency and means. The Act provides that persons who are unable, without undue hardship, to arrange GP services for themselves and family can qualify for full eligibility (a medical card). The HSE assesses applicants and awards medical cards in accordance with the Health Act 1970 (as amended) and the HSE Medical Card and GP Visit Card National Assessment Guidelines.

The HSE's Expert Group on Medical Need and Medical Card Eligibility examined the issue of awarding medical cards on the basis of illness and concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. The Expert Group also concluded that a person’s means should remain the main qualifier for a medical card. This position remains unchanged.

Nevertheless, 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. The HSE may exercise discretion and grant a medical card, even though an applicant exceeds the income threshold where they face difficult financial circumstances, such as extra costs arising from an illness.