Ceisteanna — Questions. Oral Answers. - Medical Cardholders.


asked the Minister for Health the reason for the great disparity in the number of medical cardholders as between the different health board regions; and the criteria for the issue of medical cards in each region.


asked the Minister for Health the reason only 21.25 per cent of the population in Dublin hold medical cards; and the reason 66 per cent of the population of Donegal are covered by medical cards.

I propose to take Questions Nos. 17 and 18 together.

Medical cards are issued to persons who are unable without undue hardship to arrange general practitioner medical and surgical services for themselves and their dependants.

In order to standardise procedures and ensure equality of treatment in the different health board areas national income guidelines have been adopted. The current guidelines effective from the 1 January 1983 are as follows:



Single person living alone


Single person living with family


Married couple


Allowance per child under 16 years


Allowance for other dependants


Allowance for outgoings on house excess over


Other allowance

Reasonable expenses necessarily incurred in travelling to work.

These are the criteria for determining the granting of medical cards in each area. Differences exist between counties in the percentage of the population covered by medical cards. The primary cause of these differences relates to such disparities between counties as the income pattern of the region and the age structure of the population. A study is at present being carried out which seeks to identify other reasons for these differences.

I was unable to hear all of the Minister's reply but I am not asking him to repeat it. It was very difficult to hear him. His reply sounded complicated dealing with age structures and so on. It seems extraordinary — and this has not been explained by the Minister in his reply — why there should be such an enormous disparity between one area and another. In these difficult times when medical services are so expensive and money is so short it is a matter of grave concern, particularly in Dublin city, that medical cards are not available on the same basis and granted under the same criteria as in other areas. Is there any evidence that political influence is used in other areas to dispense medical cards like confetti, as is happening?

I accept the Deputy's concern that there seems a wide regional disparity on the availability of medical cards——

Deputies cannot hear the Minister's reply because everybody is talking.

Applicants for medical cards in Donegal are examined in accordance with the regulations laid down. Will the Minister accept that the health board in that county carries out a fair assessment of all applicants and that the 66 per cent of the population who have medical cards are entitled to them under existing regulations?

I accept that assumption but I should like to point out that in Donegal 65.3 per cent of the population are covered by medical cards whereas in Deputy Mac Giolla's county the figure is 22 per cent. It would be interesting to have an investigation into income disparities per region.

Would the Minister consider initiating an investigation?

I have. In the Eastern Health Board region 22 per cent of the population are covered by medical cards; in the Mid-Western region 35 per cent; in the North-Eastern 40 per cent; in the North-Western 60 per cent; in the South-Eastern 45 per cent; and in the southern area 31 per cent. For the country as a whole the figure is 35 per cent.

Would the Minister consider initiating an investigation into the reasons for the disparities?

I have done that.

When will the result of the investigation become available?

In about two months time. It will be reflected in next year's Estimates.

The Minister says he has already initiated an investigation into the reasons for the disparities.

I have, yes.

Will the Minister include in that an investigation into the reason why two sets of criteria are used and whether it would be possible to have some degree of equity?

The Deputy and the Minister will resume their seats. It is now 3.30 p.m.

I want a reply.

I can assure the Deputy that a survey is being carried out at present seeking to identify reasons other than income patterns and age structures.

The remaining Questions will appear on tomorrow's Order Paper.

A Cheann Comhairle I put down a Private Notice Question concerning Shergar. While I accept your right to refuse that question, lest you are under the impression that the matter is not of importance and urgency I should like to give notice that I wish to raise it on the Adjournment even though this may be at a late hour.

The Chair will communicate with Deputy Power.

I want to impress on you that, while there may be other requests to raise matters on the Adjournment, because of the season of the year this is a matter of urgency not only in my constituency but worldwide. I hope the Minister will be able to make a statement today.

The Chair will take all these matters into account and will communicate with the Deputy.

I should like to have written replies to Questions Nos. 162, 181 and 206.

That will be attended to.

I should like to have a written reply to Question No. 187.

That will be attended to.

I should like to have written replies to Questions Nos. 165 and 166.

That will be attended to.

It is very difficult to hear speakers in the House. Could something be done about this before the Minister begins his speech on the budget?

That will be noted.

I should like to have a written reply to Question No. 183.

That will be attended to.