Pa Daly (Kerry, Sinn Fein)
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524. To ask the Minister for Health if he will consider expanding the criteria for granting a medical card to include patients who have a cancer diagnosis that would prove fatal without treatment. [22214/22]

Stephen Donnelly (Wicklow, Fianna Fail)
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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 undue 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 or GP visit 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 who have been certified by their treating Consultant as having  a prognosis of 24 months or less 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.