asked the Minister for Health if he is aware that the inflexibility of regulations adopted by health boards in determining medical card applications has deprived many deserving families of participation in the choice of doctor scheme.
Ceisteanna—Questions Oral Answers. - Medical Card Applications.
1.
I do not consider that the health boards apply inflexible standards in determining eligibility for medical cards. Income standards used by the boards for this purpose have regard to the number of dependants in the family, and allowances are made for certain fixed outgoings on a house, such as rent and rates. In some areas, expenses involved in travelling to work are also taken into consideration. Even where a person's income and allowances do not bring him within the standards, it is open to the chief executive officer to grant a medical card where, otherwise because of family circumstances, undue hardship would be involved. I am satisfied that the chief executive officers of health boards in general are very reasonable in the manner in which they deal with applications for cards.
Is the Minister not aware that there is a national outcry so far as the determination of applications for medical cards is concerned? The income standards laid down in the case of a wage-earner is £17 per man and wife plus £1 for each additional child, but the gross income is taken into account in determining the application. Irrespective of long standing illness of a member, or members of a family, the application is refused if the gross income is in excess of the amounts laid down.
If I might make a second point so far as self-employed people are concerned, for instance, farmers, they are obliged to have reports from the creameries and shop keepers have to furnish business reports when they apply for medical cards. Is the Minister not aware that health boards are rigid in the enforcement of regulations and do not take into account any illness suffered by one or more members of a family? Formerly such illnesses were taken into account and this should continue to obtain under the Health Act, 1970.
I should like to remind the Deputy that in the past ten years the level of industrial earnings has risen by 262 per cent and the level of agricultural earnings by 290 per cent. In spite of that fact on average 30 per cent of the population —it is 50 per cent in certain of the more depressed areas—are in receipt of medical cards. As was pointed out in the reply, there is discretion for the chief executive officer of any health board to use his own judgment where he considers undue hardship would be involved. I should like to point out that it was the express desire of Members of this House during the years that some form of standardisation in regard to the issue of medical cards should be operated. It seems odd to me that even though there is flexibility, the basis of the Deputy's complaints now is that the formulation of such standards is undesirable.
Is the Minister not aware that it costs at least £1 for a person outside the choice of doctor scheme to visit a doctor to get advice from him? This means that the person must visit the doctor again when he needs medicine or medical appliances because the prescription can be used only once. Am I to assume that the provisions in relation to families whose members suffer illness over a long period are removed now? Further, is the Minister aware that in relation to the standards laid down, the former health authority in Cork county —and I think it applied throughout the country—laid down as the qualifying——
The Deputy is making a statement.
They laid down the wage rates payable to non-skilled workers employed by local authorities. Will the Minister not agree that these standards have been changed?
The Deputy is making a statement. He is not asking a question.
I am asking the Minister if he is aware of the change that has been made. In Cork county the figure has been reduced by £5 weekly for a man and wife. In view of the exceptionally undesirable situation throughout the country and the fact that people——
The Deputy is arguing a case at this stage.
Deserving people cannot get medical cards or avail of medical treatment. I realise it is difficult to deal with this matter by way of question and answer. I am trying to avoid raising the matter on the Adjournment.
The Chair is concerned that there are 357 questions for answer.