The Minister for Health, Stephen Donnelly TD, has today published the Report of the HSE Clinical Advisory Group on Medical Cards in Cases of Terminal Illness.
The HSE Clinical Advisory Group was re-convened in December 2019 to review eligibility criteria for a medical card in cases of terminal illness and to advise of any changes deemed appropriate. The Clinical Advisory Group, which is comprised of clinical experts and patient representatives, submitted its Report to the Department of Health in September. The findings of the Report were presented to Cabinet last week.
Minister for Health, Stephen Donnelly TD, said: “I very much welcome the report of the Clinical Advisory Group and wish to sincerely thank the expert clinical membership and patient representatives for undertaking a comprehensive review of a very important and complex matter that affects many people at such a difficult stage in their lives”.
The Report makes a number of findings including:
- identifying practical and legal challenges with extending eligibility within the framework of the current process,
- proposing that legislative change be introduced to expand eligibility for medical cards, and
- advising on a number of key steps to be taken to improve the information and communication processes regarding eligibility for medical cards in cases of terminal illness.
In response to the findings of the Clinical Advisory Group (CAG), Minister Donnelly said:
There are a number of issues that need careful consideration. I am examining a number of options and my Department has devised an ambitious work programme to be initiated immediately. This includes devising legislative options that will give effect to the Programme for Government commitment to extend eligibility for medical cards for terminally ill patients. I have asked for this within 12 weeks and intend to act immediately. I have also asked that, in addition to the legislative work, officials consider proposals that would enable access to services required by those with a serious illness without necessarily requiring a medical card.
Other measures that will be undertaken to advance this issue include a Public Consultation that will ensure that the voices of patients, families, carers and advocacy group are heard in relation to this matter. Work has already begun on this.
An Information & Communication Working Group will be established by the HSE, to implement the findings of the CAG, which is aimed at bringing greater clarity, transparency and awareness amongst both patients and health practitioners to the current eligibility medical card process for the terminally ill.
Minister Donnelly stated:
I have written to the HSE to request that this work is initiated without delay and I have sought regular progress updates on these important matters. This Group will include patient advocates and will also be asked to consider if the financial burden of illnesses for everyone is appropriately taken account of, under the current processes, and to establish whether further improvements in that regard are required.
The Minister said he would also write to the Primary Care Reimbursement Service (PCRS) to ensure it is using the full discretion open to it when it comes to examining applications for medical cards.
Almost 1,800 medical cards have been issued on ‘End of Life’ criteria - that is when patients unfortunately have a prognosis of less than 12 months. In such cases the patient is not required to undergo a financial means assessment nor are they ever reassessed. In addition, it is likely that other persons who have a terminal diagnosis may also be in receipt of a medical card on either a means assessment or discretionary basis.