Vol. 270 No. 1
asked the Minister for Health if the North Eastern Health Board includes the full milk cheque of a farmer as income for medical card purposes without taking into account his costs of production such as the cost of fertilisers, feeding meals and grass seeds and any other expenses which would be allowed by an inspector of taxes in calculating a person's income; and if he will make a statement on the matter.
18.
asked the Minister for Health whether home assistance officers are allowed, when investigating applications for medical cards, to make a number of inquiries locally thereby causing gossip about the applicants as is happening at present in the North Eastern Health Board area; whether confidentiality is maintained in such applications; and if he will make a statement on the matter.
With your permission, a Cheann Comhairle, I propose to take Questions Nos. 17 and 18 together.
The determination of an applicant's eligibility for a medical card is a statutory function of the chief executive officer of a health board. In making his decision, the criterion utilised by a chief executive officer is whether or not the provision of general medical and surgical services for himself and his dependants would cause undue hardship to the applicant.
In arriving at his conclusion about a particular application the chief executive officer would be entitled to take into account income from all sources. He may also require verification of this income either by a certificate of earnings from an employer or through such inquiries as he considers necessary. Any information so obtained is treated confidentially.
The Minister did not mention anything about the cost of production. He has only taken the gross income but quite an amount has to be taken out of a farmer's milk cheque, such as the cost of fertilisers. In regard to the confidentiality question, is it correct for an officer dealing with an application to go around the neighbours, saying "Mrs. So-and-so or Mr. So-and-so" is applying for a medical card?
The Deputy is making a long speech.
It is incorrect to say that the gross amount of sales of any farm produce is regarded as the nett income for the purpose of qualification for a medical card. I have assured the Deputy that all information is treated confidentially. On some occasions, particularly when an applicant is not forthcoming with certain information, it is necessary for the home assistance officer to make further inquiries.
Could the Minister say what criteria are used in relation to farmers applying for medical cards?
The Deputy will appreciate that it is very difficult——
This is what I would like to know.
We must depend on the home assistance officer's judgment in that and, in a particular case——
He would want to be an accountant.
The difficulty in all this is that most farmers are not accountants and do not keep accounts.
Has the standard previously ruling whereby £1 rateable valuation for land equalled £20 cash income gone by the board?
This is the yardstick in respect of unemployment assistance for certain categories of farmers. I want to assure the Deputy that there has been no change in the system so far as investigation of means is concerned in respect of any applicant.
Question No. 19.
This is a very important matter. We cannot get any answers from the CEOs. One final supplementary. Could the Minister ask the CEOs to use the same criteria as is used in the Department of Social Welfare for assessment of means?
No, but if any applicant is dissatisfied with a decision which is a refusal he has the right to appeal to the CEO. This case—if I take it that it is the case Deputy Crinion mentioned—was thoroughly investigated and it was found that the applicant's means were way above the level at which he would qualify for a medical card.
How can it——
I have called the next question.
I should like to raise the subject matter of this question on the Adjournment.
The Chair will communicate with the Deputy.
19.
asked the Minister for Health if he is satisfied with the arrangements whereby the means of self-employed persons are investigated in medical card applications.
The statutory responsibility to determine whether or not an applicant is eligible for general medical services rests with the chief executive officer of the health board concerned. There are many varieties of self-employed persons and the methods whereby means are investigated must vary. I have no reason to believe that the methods used are unsatisfactory.
Is the Minister aware of the hardship suffered by medical cardholders trying to obtain spectacles under the present system? Can the Minister give any reason why these people cannot go to their usual optician to get their glasses?
This would seem to be a separate question.
The Deputy is a question ahead of me.
