asked the Minister for Health if he is aware that persons who have qualified for old age pensions after a most stringent means test have been refused medical cards by the South Cork Board of Public Assistance; and, if so, what steps he proposes to take to ensure that the services of the dispensary doctor will be made available to these persons in the lower income group in accordance with their entitlement under the Health Acts.
Ceisteanna—Questions. Oral Answers. - South Cork Board of Assistance: Medical Cards.
6.
I am aware that it may happen that a person who has qualified for the old age pension may be deemed to be ineligible for a medical card. The legal basis for entitlement to a medical card is the inability of the applicant to provide by his own industry or other lawful means the medical services necessary for himself or his dependants. In the case of an old age pensioner his domestic circumstances, including the income of his household, may be taken into account and if it is clear that his needs are adequately provided for, the health authority may decide that the applicant does not satisfy the statutory conditions which would render him eligible for a medical card.
In a Circular Letter which issued from my Department, health authorities were urged to adopt a liberal attitude to applications for medical cards from old age pensioners. I understand that, in general, they do in fact issue medical cards to such persons on application. If the Deputy is aware of any instance in which it appears that a refusal to issue a medical card to an old age pensioner has resulted, or is likely to result, in hardship, I shall have enquiries made from the health authority if he furnishes me with details. I may remind the Deputy, however, that I have no statutory functions regarding the determination of eligibility for general medical services.
Am I to take it from the Minister's reply that if I or any other Deputy furnish him with information of a case in which an old age pensioner has been refused a medical card he will look into it?
Not quite altogether that. As I have said, if the Deputy can furnish details of a case where a card has been refused to an old age pensioner which has resulted in, or is likely to result in, hardship by all means submit that case.
Is the Minister not aware that a person cannot qualify for an old age pension unless he goes through this most stringent means test, and ipso facto he must prove he is not capable of providing medical attention or hospitalisation for himself or any of his dependants? Does it not follow that he should get a medical card?
The Deputy, I am sure, is aware of the distinction between the tests in one case and the other. In the case of the old age pension, the means test applies to the income of the old age pensioner or that of his wife and to no other income. In the case of the medical card applicant, as every Deputy knows, the income of the household is, or can be, taken into consideration.
May I ask the Minister if the advisory health committees which each local authority is empowered to set up have any function in connection with the giving of a direction or advice to county managers that where persons are in receipt of old age pensions they should automatically be given cards?
Surely that is a separate matter?
It arises out of this.
It is a separate matter.
Is the Minister aware that his predecessor personally informed the members of Cork County Council that every old age pensioner in receipt of the maximum old age pension was automatically entitled to a medical card and, if so, when did the regulations change?
Will the Minister now state that any person who has been refused a medical card has the right to appeal to the Minister for Health?
Of course, such people have that all the time. However, that is not the point. This question of a direction having been given to a particular local authority by a particular Minister which may not have conformed to the statutory regulations is one on which, I am sure, I am not expected to give an opinion.
Will the Minister indicate when the change came about in the regulations in view of the information given by his predecessor to the managerial staff and the members of Cork County Council?
Will the Minister not say it is a fact that old age pensioner? who had medical cards for the past two or three years have had their cards withdrawn during the past 12 months? Can the Minister account for that?
In reply to the supplementaries, which seem to infer that there has been a change in the regulations or in policy, I can categorically state that no such change has taken place.
Will the Minister undertake to investigate any case if I give him the names of people who have had their cards withdrawn?