Michael Ring
Question:250 Mr. Ring asked the Minister for Health and Children if he will initiate a review on medical card guidelines in view of the current economy and costs of private medical cover. [18302/00]
Written Answers. - Medical Cards.
The Irish health care system is structured to ensure that a high quality health care system is available to people based on need rather than ability to pay. This commitment to the principle of equity was reinforced in the national health strategy – shaping a healthier future. In the context of this underlying principle of equity, it is considered that public funds can be utilised to best effect when those who have the means to do so fund their own care or contribute to the cost of that care. The OECD publication Economic Survey of Ireland (1997) concluded that the system based on a mixture of public and private care had "resulted in good provision of health care at a relatively low cost to the tax payer".
Under the Health Act, 1970, determination of eligibility for medical cards is the responsibility of the chief executive officer of the appropriate health board. Medical cards are issued to persons who, in the opinion of the chief executive officer, are unable to provide general practitioner medical and surgical services for themselves and their dependants without undue hardship.
Income guidelines are drawn up to assist in the determination of a person's eligibility and these are revised annually in line with the consumer price index. However, the guidelines are not statutorily binding and even though a person's income exceeds the guidelines, a medical card may still be awarded if the chief executive officer considers that his-her medical needs or other circumstances would justify this. The Programme for Prosperity and Fairness refers to the fact that health board chief executive officers are examining the operation of the medical card scheme and will consult with the social partners by the end of 2000. Particular emphasis will be placed on the needs of families with children, and on removing anomalies and barriers to take-up, including information deficits.
Michael Ring
Question:251 Mr. Ring asked the Minister for Health and Children if he will change the regulations relating to the provisions of medical cards in order to provide for the automatic provision of a medical card to children who suffer from asthma. [18303/00]
Entitlement to health services in Ireland is primarily based on means. Under the Health Act, 1970, determination of eligibility for medical cards is the responsibility of the chief executive officer of the appropriate health board. Medical cards are issued to persons who, in the opinion of the chief executive officer, are unable to provide general practitioner medical and surgical services for themselves and their dependants without undue hardship.
Income guidelines have been drawn up by the chief executive officers to assist in the determination of a person's eligibility and these are revised annually in line with the consumer price index. However, these guidelines are not statutorily binding and even though a person's income exceeds the guidelines, a medical card may still be awarded if the chief executive officer considers that his-her medical needs or other circumstances would justify this.
In view of this special provision I do not feel it justifiable, nor did previous Governments, on health policy grounds, to extend an automatic entitlement to a medical card to any specific group without any reference to their means, as a general rule. It is open to all persons to apply to the chief executive officer of the appropriate health board for health services if they are unable to provide these services for themselves or their dependants without hardship.
The Programme for Prosperity and Fairness refers to the fact that health board chief executive officers are examining the operation of the medical card scheme and will consult with the social partners by the end of 2000. Particular emphasis will be placed on the needs of families with children, and on removing anomalies and barriers to take-up, including information deficits.