asked the Minister for Health whether he is aware of the absence of uniformity between health authorities in the application of the means test to applicants for medical cards under the Health Act, and, if so, whether he will issue instructions on the matter with a view to ensuring uniform administration in this connection.
Ceisteanna—Questions. Oral Answers. - Means Test of Medical Card Applicants.
I am aware that there is not uniformity between health authorities in the determination of eligibility for medical cards.
This arises from the manner in which the relevant statutory provision is drawn. The relevant section, Section 14 of the Health Act, 1953, which replaced a similar provision in the Public Assistance Act, 1939, requires the appropriate local authority to provide the services referred to in the section for persons "who are unable, by their own industry or other lawful means" to provide the services for themselves and their dependents. The decision whether a particular person is or is not eligible is one for the health authority concerned. I have no function in the matter—there is no provision for appeal to me.
A set scale of means for determining eligibility would achieve uniformity but it was obviously never the intention of the Oireachtas that there should be such a scale and since I became Minister for Health, I have, on a number of occasions, found it necessary to remind health authorities that they should not seek to impose one but should consider every application on its merits. I am satisfied that while, on this basis, there cannot be uniformity as between one area and another, there is less danger of refusal of services to a deserving family than if there were a uniform scale.
Is the Minister aware that grave dissatisfaction exists in many health authority areas because of the severe means test applied, resulting, in many cases, in the position where persons who were formerly entitled to free medical assistance under the Public Assistance Act, 1939, are now deprived of the services of a dispensary doctor and of the rights of free medicines? Does he not think that steps should be taken to ensure that the position of such persons is not worsened as a result of the application of the Act?
I am aware that there is dissatisfaction in certain areas but I can only remind the House that in relation to that matter I have no statutory functions.
Would the Minister not consider prescribing a scale of incomes which would vary according to the number of dependents, under which a person would be entitled to a medical card, and restrict the discretionary powers of the health authorities in cases outside that scale?
I have no statutory functions in the matter but, in fact, in so far as that suggestion is concerned, I have recommended that particular course to many health authorities—that the thing would be operated for the qualification and not for the disqualification of applicants.
Further arising out of the Minister's reply I think the time has arrived when the Minister should call a conference of managers——
That is not a supplementary question.
It is a question arising out of the dissatisfaction——
But it is not a supplementary question.
I think such a conference might have been useful before the Health Bill was introduced.
I propose to raise the subject matter of the question on the Adjournment.
I shall communicate with the Deputy.