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of the term “undue hardship” as laid out in the legislation has resulted in many instances of cards being denied or withdrawn from children with very serious illnesses and debilitating congenital conditions.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.