Under the Health Act, 1970 the determination of eligibility for medical cards is the responsibility of the Chief Executive Officer of the appropriate health board. Medical cards are issued to persons who, in the opinion of the Chief Executive Officer, are unable without undue hardship to arrange general practitioner medical and surgical services for themselves and their dependants. At present almost 36 per cent of the population hold medical cards.
Income guidelines are available to assist Chief Executive Officers in the determination of a person's eligibility and these guidelines are revised annually in line with the Consumer Price Index. However, the guidelines are not statutorily binding and health boards have discretion to issue a medical card to a person whose income exceeds the guidelines if medical or other circumstances warrant it.
While no information is available on the extent, if any, to which the income guidelines on outgoings on house and travel expenses result in persons in low paid employment not being entitled to a medical card, I would of course be anxious that every person who is in genuine need of a medical card should receive one. I believe, however, that it is best to rely on the careful consideration of individual cases by the health boards rather than to introduce a provision on the lines suggested by the Deputy.
