Following our recent survey on medical cards and submitting our analysis to the Health Service Exective (HSE), MS Ireland is cautiously welcoming the recent announcement regarding the revision of access to medical cards, in particular its recommendation that medical card eligibility should be based not only on financial means but on medical need also. We also welcome the proposal of decoupling elements that are currently attached to medical card eligibility e.g. access to specialised equipment and therapeutic interventions that access to these services would be first and fore most based on clinical need and not solely on income; the inclusion of GP’s in the decision around ‘hardship’ and ‘illness burden’ being an additional factor in the assessment process.
However, we are also concerned that no time frame has been given for the introduction of this process or clear indication as to what resource will be allocated to achieve these much needed reforms.
10 Key actions by the HSE to improve system
- An enhanced assessment process which takes into account the burden of an illness or a condition;
- The greater exchange of information between the medical card central assessment office and the local health offices;
- People with a serious illness who hold a discretionary card can also be reassured that they will retain their card pending implementation of the actions to improve the operation of the scheme;
- The power of GPs to extend medical cards in difficult circumstances will be strengthened;
- A clinical advisory group is being established by the HSE to develop guidance on assessing applications involving significant medical conditions;
- The default position for medical cards given to people with terminal illnesses is that they will no longer be reviewed;
- The HSE will be empowered to provide people with therapies or appliances if that’s what they need, even in the absence of a medical card;
- The HSE will develop a single, integrated process for people to apply for a medical card, a GP visit card, the Long-Term Illness scheme, and the Drugs Payment Scheme;
- Access points will be established around the country in health offices to support and assist people to make applications;
- The Department and the HSE will consider the best way to make medical aids and appliances available to persons who do not hold a medical card, the provision of services to children with severe disabilities, and to enable people with particular needs to have these met on an individual basis rather than awarding a medical card to all family members.
Two reports were also published: The report of the Expert Panel on Medical Need for Medical Card Eligibility, and the external review of the Medical Card Process, undertaken by Prospectus and Deloitte.
Further reading