asked the Minister for Health if, because of the increases in the cost of living, he will consider increasing the scale of eligibility being used for the issue of medical cards.
Ceisteanna—Questions. Oral Answers. - Medical Cards.
3.
At present, there is no statutory level of income used for the issue of medical cards and the determination of eligibility for a medical card is solely a matter for the appropriate health authority. I understand that health authorities periodically adjust their standards of eligibility for medical cards, so as to allow for changes in the cost of living. The percentage of the population covered by medical cards has, in fact, shown virtually no change in the last four years.
Under section 45 of the Health Act, 1970, the classes of persons eligible for cards can be specified in regulations, which would be reviewed from time to time.
Will the Minister consider asking the health authorities to increase the scale because of the increase in the cost of living due to the turnover tax imposed on 1st May?
The only evidence available to the Minister would appear to indicate that this has already been done whenever the cost of living has gone up.
Would the Minister explain why the percentages of people holding medical cards are so different in different parts of the country and not necessarily in the poorest parts?
Would the Minister give a direction to the health authorities that the twelfth round increase will not be taken into account by them in issuing medical cards? This has happened in Limerick and I am sure it is the general practice of members of the County Managers' Association.
(Cavan): In view of the Minister's statement that each health authority fixes its own standard, would the Minister not consider it would be desirable to have a national standard? Does the Minister realise that when patients from various parts of the country meet in city hospitals and exchange views on this matter there is grave dissatisfaction when one finds that one has a health card and another person who is worse off from a different part of the country has none?
As I have already said, section 45 of the Health Act, 1970, makes provision for some uniformity by specifying basic means.
Was it not always the duty of the Minister's Department to ensure that there would be uniformity throughout the country? We have heard a great deal about the three Departments associated with local government being supposed to have uniformity of administration. There is no such uniformity in relation to medical cards. The Minister did not answer my question on the last occasion. I should like him to answer it now.
As one who was a member of a health authority for many years, I used argue that there was a lack of uniformity in the system but when one got down to examine it one found that the variation was not much.
When one became Minister, the Minister means.
Is it not a fact that only 8 per cent of the people of County Dublin have medical cards, whereas 40 per cent of the people in County Limerick have medical cards? Is that not a fact?
No.
It is a fact, because the Minister's Department supplied us with the information.
I gather from the Minister that he agrees with the increase in the cost of living from 1st May. In view of that, would he recommend to health authorities that they should now increase the scale of eligibility?
That is a different question.
I do not think so. It arises out of the Minister's reply.
I want an answer to my question about the twelfth round increase.
There is nothing in this question about the twelfth round increase. With all the talk about lack of uniformity one must support the method whereby local people with the local home assistance officer can investigate cases and gain much more intimate knowledge of them than any central authority could gain. There may be something against lack of uniformity but here is a method that can be used locally and the elected representatives are present to ensure that it is fairly used. It is part of their constant duty to ensure that.
We cannot discuss this question all evening.
Surely the Minister will agree that where there is no criterion it is impossible for local representatives to make any representations?
Will the Minister ask them to increase the scale of eligibility? It is now becoming a hardship on people who are just above the limit. Because of the increase in the cost of living, they are not in a position to provide their own medical services. I think the scale should be increased in fairness to a large number of people who are on the margin of eligibility.
I cannot get a medical card out of the Dublin Health Authority for anybody.
I want to know will the twelfth round increase be assessed against the applicant for a medical card? It has happened in Limerick that medical cards were withdrawn because of the twelfth round increase. That increase came about because of the cost of living and these medical card holders are now being deprived of their cards. Will the Minister make a statement to the County Managers' Association?
No.
Why not? It is the Minister's duty.