asked the Minister for Health why persons in receipt of non-contributory old age pensions are being refused medical cards in view of the fact that the Department of Social Welfare regulations state that they are automatically entitled to them; and if he will make a statement on the matter.
Ceisteanna—Questions. Oral Answers. - Medical Cards.
1.
The position concerning the eligibility for medical cards of non-contributory old age pensioners was explained in a statement which I made in reply to a question by Deputy Kitt on 25th May, 1976, Official Report, Volume 291, No. 1, columns 8 to 11. The position remains that the holder of a non-contributory old age pension could have an income which would place him outside the medical card guidelines but that, in a great majority of cases, persons who are in receipt of such pensions at the full rate are clearly within the guidelines and consequently qualify for medical cards.
While I am aware that a notice which is issued to pensioners by the Department of Social Welfare advises the recipient that if he wishes to obtain a medical card he should apply to his health board, I do not know of any statement in regulations under the Social Welfare Acts to the effect that persons in receipt of non-contributory old age pensons are automatically entitled to medical cards.
Is the Parliamentary Secretary aware that according to the information hand-out issued by the Department of Social Welfare non-contributory old age pensioners are automatically entitled to medical cards?
I have here a copy of the hand-out issued by the Department of Social Welfare and under the heading "medical cards" it says that if you wish to obtain a medical card you should apply to your local authority or health board stating that you are in receipt of non-contributory old age pension and quoting your pension number. I agree there is an implication there that you might be entitled to a medical card and we are asking the Department to reword that section and state the position more clearly.
Has a direction been issued by the Minister for Health cancelling this arrangement? Up to very recently recipients of non-contributory old age pensions were automatically entitled to medical cards. They had to apply for them but they were automatically granted once they were in receipt of a non-contributory old age pension, even at a reduced rate.
I can assure the Deputy that no such direction was given by the Minister for Health.
Mr. Kitt
Is the Parliamentary Secretary aware that no progress has been made with regard to this problem since I raised it last May? Is he further aware that in view of the fact that the same Minister is responsible for social welfare and health there is unnecessary duplication in having two inspections for the person who wishes to apply for an old age pension and a medical card and that the two inspections seem to be contradictory?
I am sure the Deputy will agree that the number of cases in which this could happen would be minimal.
Arising out of the Parliamentary Secretary's reply, there is this difference——
A question please, Deputy.
For a single person, under the old system, not living alone and in receipt of the full old age pension, the full allowance was £17.50. The old age pension was £10 and the maximum income these people could have outside the pension was £6. That amounted to £16. Yet a person who applied to two different Departments under the same Minister for a health card was refused. This means that——
The Deputy is making a statement instead of asking a question.
His means for social welfare were assessed differently from the way they were assessed for a medical card.
Statements are not in order at Question Time.
I am asking a question.
It is not a question. I am anxious to facilitate the Deputy in asking questions but I must dissuade him from making statements.
I am not making a statement. I am asking why there is a difference between the way the Department of Social Welfare assess income and the way the health boards assess income for a medical card. I have proof that there is a difference. A single person who qualified for the full old age pension had a total income of £16. Yet when he applied for a health card he was refused. Why is there that difference?
I agree there is a difference. What happens here is that the qualifying allowances for old age pensions have been considerably eased in the past few years by the Coalition.
That is no answer.
Would the Parliamentary Secretary not accept that in future all recipients of non-contributory old age pensions should be automatically entitled to medical cards as they were up to recently? Would he issue instructions to the health boards that they carry out this instruction?
The CEOs of the different health boards have the responsibility of ensuring that the guidelines are working properly. If the Deputy knows of any non-contributory old age pensioners who are not medical card holders, I would like to know about them.
If the Parliamentary Secretary goes to a little trouble, he may find that the Minister's predecessor, Mr. McEntee, said at one time that one means test was enough for people in that category.
2.
asked the Minister for Health the number of medical cards that have been withdrawn by the Western Health Board in the last twelve months.
During the year 1976 a total of 8,534 medical cards were cancelled in the Western Health Board's area. During the same period 11,244 new cards were issued, giving a net increase of 2,710.
Will the Parliamentary Secretary accept that in the last figure he quoted he was giving the figure for young people of more than 16 years who would qualify for medical cards? In relation to the first figure he gave, will he accept that it seems rather strange in view of the fact that the figures given as guidelines have been increased that the health boards are taking up so many medical cards?
I am not sure how those figures were arrived at but I am sure the Deputy will agree that the increase of 2,710 medical cards in the area indicates that the health board officers are quite liberal in their interpretation.
The Parliamentary Secretary must be honest with the House. Will he accept that the last figure he gave relates to the issuing of cards to young people of more than 16 years? Further, will he accept that many people, even those on social welfare, now find themselves without medical cards? Will he tell the House what guidelines are being used?
I am afraid that new matter is being introduced into the question.
The figures are those as at 31st December, 1975 and 31st December, 1976. They are the latest figures available to me and I have given them to the Deputy.
Am I correct in stating that the figure given as a guideline has been increased from £28.25 to £34 for a man and wife? I understand that no allowance is now being made in respect of the stamp as was the case before.
The scope of the question is being widened considerably by Deputies.
I asked a supplementary question that is relevant to the issuing of medical cards. Even though the guideline has been increased to £34, there is no allowance given in respect of the stamp. Will the Parliamentary Secretary state if that is the position?
I was asked a question regarding the number of medical cards withdrawn and I have given the information twice.
Does the Parliamentary Secretary not think it strange that farmers whose rateable valuation is as low as £6 are being refused medical cards because the health boards state their income from land in addition to social welfare exceeds the amount set as a guideline?
We are having a continuation of Question No. 1. This question deals with the number of cards withdrawn. I am calling Question No. 3.