Eligibility for medical cards to be extended by Coalition

The Government has insisted its plans to introduce free GP care for all are still on track, despite an embarrassing climbdown yesterday over discretionary medical cards.

Patients who lost discretionary cards over the past year have been promised their early return once legislation promised by the Government to allow for cards to be granted on the basis of designated medical conditions is implemented.

The decision to extend eligibility on the basis of medical condition, rather than financial means alone, marks a major reversal of policy. Only two years ago, the Government abandoned plans to extend free GP care to people with long-term illnesses because of legal difficulties.

Minister for Health James Reilly’s officials have been tasked with developing plans for the further roll-out of GP care. Sources said this did not mean the current plan to extend free GP care to under-sixes in the first phase is in jeopardy, although there is no prospect of this happening before the summer as originally promised.

The decision to suspend the ongoing review of discretionary medical cards was made by the Cabinet subcommittee on health yesterday and announced by Minister of State at the Department of Health Alex White in the Dáil. It followed months of criticism over the removal, refusal and downgrading of medical cards for people with serious medical conditions.

New framework

The review is being suspended while a new framework for awarding medical cards is drawn up, which will for the first time take account of a person’s medical condition.

Up to now, medical cards were awarded on the basis of financial means, although the HSE may exercise discretion where an applicant suffers hardship because of major medical need. Mr White said the Government was very aware of public concern on the issue. As a result, the Cabinet subcommittee had decided a policy framework should be drawn up in a manner in which medical conditions were taken account of in the assessment of eligibility for a medical card.

Expert panel

An expert panel will be convened to decide on the range of conditions which would be relevant in this regard, he said. “This process will include the development of a new legislative framework as necessary.”

The HSE would suspend the current review of medical cards where discretion was exercised to take account of medical circumstances.

The Department of Health is to draw up a policy paper setting out the path toward full roll-out of free GP care for all and the Minister for Health would bring a memo to Government on the issue, he said.

A spokesman for Dr Reilly said this paper would take account of yesterday’s decision in moving towards free GP care for all, which is promised in 2016.

Mr White pointed out that there are significant regional variations in the award of discretionary medical cards, from 24 per 1,000 cards in Co Cork to four per 1,000 in Co Meath.

Asked what would happen to patients who have lost their discretionary cards, the HSE said the changes they require to become eligible on the basis of medical circumstances would form part of the development of the legislative framework and the work of the expert panel.

“It is not envisaged this would be a lengthy process,” a spokeswoman said. In the interim, most of those affected will have been granted GP visit care or qualify for the long-term illness scheme.