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Health | Medical cards approval expediency

To ask the Minister for Health if he will give a personal direction to ensure that patients will life threatening illnesses are offered medical cards without incessant reviews on financial grounds or otherwise; and if he will make a statement on the matter.

To ask the Minister for Health if he is satisfied that patients with serious life-threatening conditions have had their applications for a medical card approved with sufficient expediency given the nature of their condition; and if he will make a statement on the matter.

To ask the Minister for Health if patients with a life-threatening condition are likely to have their application for a medical card issued with sufficient expedition having regard to their medical needs and expected compassionate response; and if he will make a statement on the matter.


With regard to the Deputy’s request that I give a personal direction, under the Health Act 2004, the Health Service Executive (HSE) is required to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. Section 6 of the HSE Governance Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual.

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.

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.

I can advise the Deputy that the HSE has guidelines in place in relation to the provision of emergency medical cards to patients that are terminally ill, or are seriously ill, and in urgent need of medical care that they cannot afford. Instances where it would be appropriate to apply for emergency consideration include acute medical crises whereby access to services covered by medical card eligibility is required urgently and the client has no means to pay for same privately.

With the exception of terminally ill patients, all emergency medical cards granted are issued for 6 months 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.  I am advised by the HSE that such medical cards are active on the system within 24 hours of the HSE National Medical Card Unit receiving a medical report and completed application form from a healthcare professional.

I can assure the Deputy that I endeavour to ensure that the medical card system is responsive and sensitive to people’s needs. My Department keeps medical card issues under review and any proposals are considered in the context of any potential broader implications for Government policy, the annual budgetary estimates process and legislative requirements arising.

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