asked the Minister for Health if persons in receipt of full non-contributory old age pension will be automatically eligible for medical cards.
Ceisteanna—Questions. Oral Answers. - Medical Card Eligibility.
6.
Mr. Kitt
Entitlement to a medical card depends on whether a person is unable without undue hardship, to arrange general practitioner medical and surgical services for himself and his dependants. The normal criterion used in determining eligibility is whether the income of the applicant falls within the income guidelines which have been fixed by the chief executive officers of the health boards for this purpose.
In the case of applicants who are in receipt of pensions or allowances which are subject to means tests which are more stringent than the guidelines for medical cards, the chief executive officers have adopted the practice of regarding such persons as eligible without subjecting them to any further means testing. Non-contributory old age pensioners were in this category, but it has recently come to the notice of the chief executive officers that the holder of such a pension could have an income which would place him outside the medical card guidelines. In the great majority of cases, however, persons who are in receipt of full non-contributory old age pensions are clearly within the medical card guidelines and are accepted as being eligible for medical cards.
The Minister has said that the vast majority of those in receipt of the full old age pension are entitled to medical cards. However, a husband and wife can have £12 per week and yet qualify for the full non-contributory old age pension which is more than £20, thereby bringing their total income to about £32, whereas the guideline set down by the Western Health Board in respect of a medical card is £28.25 for a married couple. Is this not putting them outside the point of eligibility?
The Deputy's figures are accurate. It is possible for a married couple to qualify for a pension of £35 per week and this would put them outside the guideline in regard to eligibility for a medical card since the deciding figure is £28.25.
We have understood that anyone in receipt of a full old age non-contributory pension was entitled to a medical card but that is not so in practice because a couple could have an income of £3 more than the guideline. I am endeavouring to indicate why the guideline is so wrong.
This situation arises as a result of the improvements in the social welfare code, particularly in relation to the means test.
Would the Minister agree that the introduction of this measure as a means of economy may very well be a form of false economy, that if everything were taken into account the former practice of granting these people medical cards automatically would be the most economic way of proceeding because it would avoid further investigation of cases which have been investigated fully already by officers of the Department of Social Welfare? Would he not agree that, perhaps, it would be not only more humanitarian but also better economy to resort to the former practice and to abolish this niggling economy he has introduced?
The practice to which the Deputy refers applies to two health boards, the Western Health Board and the South Eastern Health Board. As I pointed out to Deputy Callanan——
I saw a circular from the Southern Health Board to the same effect.
The only information I have is to the effect that this is operated by the Western Health Board and by the South Eastern Health Board. Again, may I point out to the Deputy that it is possible—in very few cases—for a married couple's income to exceed the guidelines? Income is income no matter what way one takes it. As I said, the generosity——
What?
The generosity of the attitude of the Government towards social welfare and the means test has meant that these people could have reasonable incomes which would take them approximately £10 or £11 above the guidelines.
Question No. 7.
Is the Minister seriously suggesting that a government which takes medical cards from non-contributory old-age pensioners is a generous government?
The Government do not do it themselves. It is determined by the CEOs and I have asked the CEOs to have a unified approach to it.
The Minister takes the credit but allots the blame.
(Interruptions.)
Order. I am passing on to the next question.
I have got to provide the money no matter what happens.
A final supplementary——
Question No. 7.