Under the Health Act, 1970, 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 medical and surgical services for themselves and their dependants.
Income guidelines are drawn up by the chief executive officers to assist 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 or other circumstances would justify this. Assessment procedures are also a matter for the chief executive officers.
I have had inquiries made of the South-Eastern Health Board concerning this case and have been informed that the person's financial assessment was substantially in excess of the medical card guidelines. Following further assessment on medical grounds the person was deemed ineligible for a medical card.
I am advised, however, that the person is the holder of a drugs cost subsidisation scheme (DCSS) card since May 1996. The DCSS is available to persons who do not hold a medical card, but who are certified as having a long-term medical condition, usually in excess of twelve months, with a regular and ongoing requirement for prescribed drugs and medicines costing in excess of £ 32 per month. Eligible persons are obliged only to pay £ 32 each month to their community pharmacist in respect of all prescription medication dispensed to them. In the absence of this card the person would have to pay for all medication dispensed to them by their community pharmacist, though they could, of course, under the drug refund scheme, later claim from the local health board, a refund of any cost incurred in excess of £ 90 in a specified three month period.