Peadar Tóibín (Meath West, Aontú)
Link to this: Individually | In context | Oireachtas source

172. To ask the Minister for Health the criteria for cancer patients to qualify for a medical card; and if there are plans to amend the criteria to expand eligibility for cancer patients. [59159/21]

Stephen Donnelly (Wicklow, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

Under the Health Act 1970, eligibility for a medical card is based primarily on means. The Act obliges the HSE to assess whether a person is unable, without due hardship, to arrange general practitioner services for himself or herself and his or her family, having regard to his or her overall financial position and reasonable expenditure.

The issue of granting medical cards based on having a particular disease or illness was previously examined in 2014 by the HSE Expert Panel on Medical Need and Medical Card Eligibility. The Group concluded that it was not feasible, desirable, nor ethically justifiable to list medical conditions in priority order for medical card eligibility. In following the Expert Group’s advice, a person’s means remains the main qualifier for a medical card.

However, 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. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.  

Furthermore, the HSE also has a system in place for the efficient provision of medical cards in response to emergency situations i.e. in circumstances where persons are in need of urgent ongoing medical care or are receiving end of life care.  In these cases, a medical card is issued within 24 hours of receipt of the required patient details and completed medical report by a healthcare professional.  Additionally, patients with a terminal illness and who have been certified by their treating Consultant as having  a prognosis of 24 months or less to live are also now eligible for a medical card without a means assessment.  

Finally, it should be noted that since 2015 medical cards are awarded without the need of a financial assessment to all children under 18 years of age with a diagnosis of cancer, for a period of five years.

Peadar Tóibín (Meath West, Aontú)
Link to this: Individually | In context | Oireachtas source

175. To ask the Minister for Health if his attention has been drawn to instances in which dentists are blanket refusing to see medical card patients; and the efforts his Department is undertaking to solve this problem. [59162/21]

Ruairi Ó Murchú (Louth, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

193. To ask the Minister for Health the expected timeframe the substantive review of the dental treatment services scheme will take place; the immediate issues of concern; the measures taken to address same; and if he will make a statement on the matter. [59313/21]

Ruairi Ó Murchú (Louth, Sinn Fein)
Link to this: Individually | In context | Oireachtas source

194. To ask the Minister for Health the engagements he has had with an association (detail supplied) regarding the dental treatment services scheme; the content of these discussions, detailing any future planned engagements; and if he will make a statement on the matter. [59314/21]

Stephen Donnelly (Wicklow, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I propose to take Questions Nos. 175, 193 and 194 together.

A new National Oral Health Policy, Smile agus Sláinte, was launched in April 2019. That Policy set out the roadmap for the future provision of oral healthcare to the eligible population. It has two key goals; first, to provide the supports to enable every individual to achieve their best oral health, and second, to reduce oral health inequalities across the population, by enabling vulnerable groups to access oral healthcare and improve their oral health.

The Dental Treatment Services Scheme (DTSS), which dates from the 1990s is available to medical card holders aged 16 and over. The dental care is provided by independent dental practitioners who have a contract with the HSE. There is a need to align the DTSS with best international evidence and practice, and legislation, as outlined in Smile agus Sláinte. Regretfully, the COVID-19 pandemic caused the roll-out of the Policy to be delayed and the proposed review of the DTSS contract to be deferred.

Nevertheless, there has been continued engagement between my officials, the HSE and the dental community throughout the pandemic on infection control measures, guidelines for safe dental practice, and ensuring that dental professionals were included in the high-risk group for early vaccination. This sustained engagement was with a view to ensuring that a safe satisfactory service could be continued for the eligible population.

It is regrettable that a significant number of dentists chose to leave the Scheme that provides care for medical card patients during the pandemic, which  has led to difficulties for medical card patients in accessing dental care in some parts of the country . In such circumstances, I have been assured that the HSE Public Dental Service is seeking to provide emergency cover for any medical card patients who are experiencing such problems.

I have acknowledged that there is a need for a substantive review of the DTSS and have given a commitment that the review would be undertaken. I have also acknowledged the need to address immediate issues of concern with current arrangements under the Scheme.

I instructed my officials to hold talks with the Irish Dental Association (IDA) to address both issues. I am aware that preliminary talks were held in June this year and that it is proposed to hold further talks in the coming weeks.