I propose taking Questions Nos. 44 and 58 together. Representations have been made to my Department in relation to children born with limb deficiencies. Under the 1970 Health Act, medical cards are issued to persons who, in the opinion of the Chief Executive Officer of the appropriate health board are unable, without undue hardship, to provide general practitioner services for themselves and their dependants.
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, these guidelines are not statutorily binding and even though a person's income exceeds the guidelines, that person may still be awarded a medical card if the Chief Executive Officer considers that the person's medical needs would justify this.
In view of this special provision I do not think that it is justifiable to extend an automatic entitlement to a medical card to any specific group without any reference to their means or, in the case of children, to their parent's means, particularly in view of the many areas of pressing need in the health services and the limited resources available to meet them.
As far as services provided under the General Medical Service are concerned, the treatment and care provided by general practitioners for medical card holders and their dependants would include the provision of advice and counselling where appropriate. If additional services in the nature of counselling are required, the general practitioner will arrange for referral to the relevant service.