asked the Minister for Health when it is proposed to ignore the income of members of a household, other than a spouse, in the assessment of means for medical card purposes.
Ceisteanna—Questions. Oral Answers. - Medical Card Means Test.
8.
Section 45 of the Health Act, 1970, is the provision relevant to this. This section removes doubt as to whether, in assessing entitlement to the general medical service, other means as well as the person's own and that of his spouse should be taken into account. I have not yet determined the date of commencement of this section. I feel that it would be advantageous for each of the chief executive officers of the health boards to have an opportunity, for some months after 1st April next, to review and co-ordinate the existing practices as regards eligibility in the counties within his board's functional area, prior to the full application of the new law on this matter. As the Deputy will be aware, it is necessary to continue for some time after 1st April next the dispensary service at present operated by local authorities under section 14 of the Health Act, 1953.
Would the Minister not agree that it is now some considerable time since Oireachtas Éireann voted in favour of abolishing the old provisions whereby income other than the income of the spouse was brought into consideration and, having regard to the fact that the Minister in this House gave us figures estimating the additional cost which would fall on the Exchequer, would the Minister not consider that the various administrative excuses which he has now offered are, in fact, unreal and that it is unnecessary to delay this much-needed benefit any longer?
I am giving a very real answer in regard to this matter. The situation varies from county to county. It would be quite wrong to make a decision as to when to operate this decision until the chief executive officers had some time to examine the extent to which standards in applying the medical card principle varied from one county to another. In some counties the proposal has an element of reality already in assessing whether a person should receive a medical card or not. In some counties old age pensioners automatically get medical cards, regardless of the incomes in the family.
Would the Minister not agree that the present system is unjust and that it is time that a uniform assessment of qualification for the medical services was made?
I have already said that part of the provisions of the Health Act involves a standardised system throughout the country. It will not be an easy matter to determine. First of all, there would have to be reports from the chief executive officers as to what the standards are, and how far they vary, and as to how far a proper standard can be assessed bearing in mind the differences which exist between the counties. In one county 47 per cent of the entire population would have medical cards, and in another county where the general wealth of the county would appear to be about the same you might have 29, 30 or 35 per cent of the people with medical cards. Chief executive officers will have to think about the whole matter.
The regional boards were to come into operation on the 1st April. The Minister did not anticipate that this uniform system would be in operation then.
I was hopeful of getting the benefits brought about as soon as possible but, as the Deputy knows, this is a complete change of administration. It is almost like starting eight new branches.