Thursday, 9 July 2009
Dáil Eireann Debate
313. Deputy Róisín Shortall asked the Minister for Health and Children if, in respect of the consideration of applications of medical cards, she will provide a copy of the guidelines followed by staff in respect of applications from terminally ill patients. [29807/09]
Minister for Health and Children (Deputy Mary Harney): The Health Service Executive (HSE) has the operational responsibility for the General Medical Services (GMS) Scheme which includes the medical card and GP visit card benefits.
Terminal illness itself is not a qualifying condition for receipt of a medical card. However, it is an indicator that a person may have exceptional medical expenses and all such expenses and associated costs are considered under the discretionary powers of the HSE to grant cards in exceptional circumstances.
Where the HSE invokes this discretion they do so in a consistent manner and be cognisant of the potential myriad of circumstances that might prevail in individual cases. The following guidelines have been developed to ensure that fairness and equity is applied to all applicants seeking either a Medical Card or a GP Visit Card.
If a person’s means are in excess of the relevant income guidelines then a decision must be taken to grant or refuse either a Medical Card or GP Visit Card. In this context the issues taken into account are additional and exceptional circumstances as outlined as follows.
3. If the applicant’s means is in excess of the GP Visit Card guidelines the deciding officer must consider whether it would be unduly burdensome for the applicant to provide for GP Services for him/her self from his/her own resources.
The exercise of discretion by the HSE, in favour of the applicant, should be considered where meeting the costs of services covered by a Medical Card or a GP Visit Card compromises the applicant’s or his/her family’s ability to meet the essential costs associated with:
A decision should only be taken after a sufficient and reasoned assessment of all the circumstances of an individual case to include the nature and extent of personal, medical or social circumstances of the applicant and/or his/her family. A Medical Card/GP Visit Card should be issued, if, having had due regard to all the relevant circumstances, it is considered that “undue hardship”would occur or that it would be “unduly burdensome”to provide GP, medical or surgical services. Where a Medical Card has been granted to a person to prevent undue hardship or where a GP Visit Card is granted because it would be unduly burdensome, eligibility should normally be extended to all dependents of that person. If in the assessment it is obvious that the predominant costs factor for the applicant is the cost associated with GP visits, the case may be dealt with by granting a GP Visit Card.
By following the approach provided for in these guidelines, the HSE will ensure that the system is adequate enough to respond to the myriad of circumstances and hurdles faced by a diverse group of individuals in society.
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