The Health Act of 1970 sets out the terms around which ‘the medical card’ operates.

Only those in receipt of weekly social welfare payments and those resident in Ireland but working in other EU countries have an automatic entitlement to a medical card.

If you fall outside of these groups, the simple fact is, no matter how ill, no matter how severe a condition your child has, there is no legal entitlement to a medical card in Ireland unless your circumstances meet the terms of a crude, out-dated means test. Failing that, the success or otherwise of your application relies solely on the discretion of the HSE.

These “discretionary” medical cards, as they have become known, can be issued based on an assessment of your medical and social circumstances to establish whether “undue hardship” would occur if you did not get a card. For whatever reason, the HSE’s interpretation of the term “undue hardship” as laid out in the legislation has resulted in many instances of cards being denied or withdrawn from children with very serious illnesses and debilitating congenital conditions.

The situation has been further exacerbated by the centralisation of the application process in to a single national office in June 2011 followed by changes to the means test in April 2013 – repayments on home loans are no longer taken in to account, and a standard travel allowance of €50 a week no longer factored in to the means calculation. The end result is that increased numbers no longer come within the terms of the means test and have no option but to apply for a discretionary card on grounds of “undue hardship” to a centralised office.

Aside from the difficulties parent’s are facing in obtaining and retaining a full medical card for their children, the application process itself is onerous, ambiguous and complex. Any parent having received a devastating diagnosis for their child should not have to engage in such a process once, let alone a number of times. Parent’s should be free to devote all their energies to caring for their child as they attempt to cope with a diagnosis that has turned their lives upside down.

The legislation governing the award of medical cards does not mention the phrase medical cards. Instead, it describes people who have “full eligibility” for health services.

In effect, if you have a full medical card, you are fully eligible to avail of all publicly run health services in Ireland together with required drugs & medicines free of charge.*

Services covered:

• All inpatient treatment and maintenance in public hospitals.
• All outpatient services in public hospitals.
• All approved prescribed drugs and medicines *(subject to a prescription charge of €2.50 per item).
• All GP/family doctor services.
• Medical services for mothers and infants.
• Some dental, ophthalmic and aural services.
• Some community care services.

If your child is diagnosed with a serious illness or born with a serious congenital condition, the medical card is vital.

It is the ‘passport’ for health care in Ireland. It is, if you have it, the tool that will enable a family dealing with a serious diagnosis to put aside their worries about costs associated with healthcare and medication, and focus all efforts on the child.

These families are staring in to the unknown.  Children born with a serious congenital condition are often faced with a life time of health complications and needs.  Their uncertain future is further complicated by a medical card application process that fails to acknowledge the severity of the illness, the reality of the condition or even basic medical facts relating to both.