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Dáil Éireann debate -
Thursday, 28 Nov 1968

Vol. 237 No. 9

Ceisteanna—Questions. Oral Answers. - Medical Card Holders.

152.

asked the Minister for Health the percentage of the population of Dublin holding medical cards on 30th September 1967 and 30th September 1968.

It is presumed that the Deputy's question relates to Dublin County Borough.

The percentage of the population of Dublin County Borough holding medical cards on 30th September, 1967 and 30th September, 1968 was 19.6 and 20.4 respectively.

153.

asked the Minister for Health whether he has issued a direction to health authorities not to grant medical cards to applicants who have motor cars taxed in their names; if not, whether he is aware that health authorities are refusing medical card applications for this reason alone, despite the fact that in many cases the car was purchased, maintained and taxed by relatives living away from home in order to provide a family comfort; and whether he will make a statement on the matter.

I have issued no such direction.

I am not aware of the position in all health authority areas, but inquiries which I have made from a number of them indicates that they would not refuse a medical card to a person merely because he owns a car where it is established that he needs the car for the purposes of his employment.

I understand that some health authorities are not prepared to give a medical card to a person who owns a car purely for social reasons. Prima facie this does not appear to be an unreasonable approach to the authority's responsibility to issue medical cards only to those who are unable to provide medical services for themselves and their dependants.

The Minister should ask again or cause some investigation to be made because it seems to me that in many health authorities the very fact that you have a car means that you are out for the medical card. All of us have this experience. A person is out if he runs a car in order to get to work.

Perhaps if the Deputy would raise a question on a specific area because the Minister has obviously made inquiries in a sample of areas and they would not act in the manner in which the Deputy suggests.

Will do.

154.

asked the Minister for Health if he will advise local authorities to take into account the cost of travelling to and from work, when deciding on a person's entitlement to a medical card.

The criterion for establishing entitlement to a medical card is that the applicant is unable, by his own industry or other lawful means, to afford the services of a general practitioner. I have not issued, nor do I propose to issue, advice to health authorities about the specific matters which they should take into account in deciding, in particular cases, whether or not to issue a card.

I am sure the Minister knows as we all know that the issue of medical cards is determined by the amount of money that the local authorities are prepared to spend on health services, just that.

I do not know that it would be fair to all health authorities to say that. It may be true of those of which the Deputy is aware.

It is determined by the amount of money available I am sorry to say.

On at least one occasion I had the experience in a byelection campaign of coming across a case where the son of the old lady in case house came home from America, bought a car for his holidays and left it as a present to the mother when he was going back and this deprived the mother of a medical card, so it does happen.

The answer I gave was on the basis that if a person can afford to run a car for a social purpose only, not requiring it for work, then the health authority might regard such a person as one who could afford general practitioner fees which are never very high.

The Minister for Labour would only know about maternity cases.

155.

asked the Minister for Health if he is aware that Dublin Health Authority are rejecting an increasing number of applications for medical cards from those who already held cards and whose circumstances have not changed; if this follows any direction from his Department; and if he will make a statement on the matter.

I am not aware that Dublin Health Authority are refusing to renew the medical cards of persons whose circumstances have not changed and my Department has not issued any direction on the subject.

The Minister will be aware of the fact that because of some direction the Dublin Health Authority have been making an increased number of refusals to applicants for medical cards since September and that people who had medical cards for years, including some whose circumstances have not changed, are being refused. I should like to know why because we cannot get a satisfactory answer from Dublin Health Authority. The direction has come from somewhere and I think it has come from the Minister's Department.

On inquiry from the Dublin Health Authority as to whether they were rejecting medical card renewals even where circumstances had not changed the health authority denied it. They picked sample refusals to renew cards and found that in each case the circumstances of the person involved had improved.

Did the health authority mention a specific case I directed to their attention?

Four cases of refusals, where the Deputy had made representations, were examined and the certified income was much higher than what the Deputy said it was.

The Minister is suggesting what I have said is wrong and I am telling him now that I notified the Dublin Health Authority of cases where circumstances had not changed and where the people were rejected for renewal of a medical card. It seems terribly strange that so many people are being rejected who had medical cards for years and whose circumstances did not change at all in some cases and in others did not change materially.

Without mentioning names or descriptions which would identify the people, in one case referred to by the Deputy the earnings were said to be £12 10s. a week and the certified earnings were ascertained to be £23.

The other ones?

In another the earnings were supposed to be £12 4s. a week and the certified earnings were £25, which again is a difference.

What about the other two? You mentioned four.

In these two at least the earnings seem to be twice as much.

Is the Minister aware of the fact that I made representations on behalf of people at the rate of about 70 a week?

These are four the Deputy made representations on and the earnings were well above the average for medical cards.

What does the Minister consider to be average earnings for medical cards?

We cannot discuss this any further. Question No. 156.

The Minister mentioned two other cases.

The Deputy is looking for punishment. I have not got the other two cases but the two examples I have given——

Two extreme examples chosen by the Dublin Health Authority. I made representations at the rate of 70 a week and I will very quickly publish a few of the cases.

If I were given half the true figure in two cases I think I would accept the point made.

I am calling Question No. 156.

I think the Dublin Health Authority deliberately did this.

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