Dáil Éireann debate -
Tuesday, 3 Feb 1998

Vol. 486 No. 3

Written Answers. - Medical Cards.

Richard Bruton

Question:

178 Mr. R. Bruton asked the Minister for Health and Children if he will introduce automatic eligibility for medical card to persons with no other income than a contributory social welfare pension; and if he will make a statement on the matter. [2542/98]

Minister for Health and Children (Mr. Cowen)

Entitlement to health services in Ireland is primarily based on means. Under the Health Act, 1970, 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 to provide general practitioner medical and surgical services for themselves and their dependants without undue hardship.

Income guidelines are drawn up by the chief executive officers to assist in the determining of a person's eligibility and are revised annually in line with the consumer price index. It should be noted that these guidelines are higher for persons aged 66-79 and higher again for those aged 80 and over. 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. Medical cards may also be awarded to individual family members on this basis.

In view of this special provision it is felt it is not justifiable, on health policy grounds, to extend an automatic entitlement to a medical card to any specific group without any reference to their means, as a general rule, particulalry in view of the many areas of pressing need in the health services and the limited resources available to meet them. It is open to all persons to apply to the chief executive officer of the appropriate health board for health services if they are unable to provide these services for themselves or their dependants without hardship. It would appear that in most circumstances a person whose sole income is a contributory social welfare pension would be entitled to a medical card.

Notwithstanding the arrangements referred to above the Government has identified as a key priority in its programme, An Action Programme for the Millennium, a review of medical card eligibility for the elderly and large families and my Department has made the necessary arrangements to advance this review with the health boards.

The following table sets out the income guidelines used by the health boards in the assessment of applications for medical cards:

Table of Income Guidelines.

The income guidelines for 1998 are as follows:

(Gross income less PRSI deductions).

	Per week
	£
Single person living alone (under 66)	89.00
Single person living alone (66-79)	97.00
Single person living alone (80 or over)	101.50
Single person living with family (under 66)	79.00
Single person living with family (66-79)	84.00
Single person living with family (80 or over)	87.00
Married couple (under 66)	129.00
Married couple (66-79)	144.50
Married couple (80 or over)	151.00
Allowance for each child under 16	15.50
Allowance for other dependants	17.00
Allowance for House expenses: (e.g. rent, mortgage) — in excess of	15.50
Allowance for cost of travelling to work: Cost allowed per week over	14.00

Liam Aylward

Question:

179 Mr. Aylward asked the Minister for Health and Children the reason for the delay in issuing a medical card to a person (details supplied) in Dublin 6. [2543/98]

Minister for Health and Children (Mr. Cowen)

I have had inquiries made of the Eastern Health Board concerning the case raised by the Deputy and have been informed that a medical card application form was received from the person concerned on 14 October 1997. I also understand that following receipt of the application form the health board requested additional information from the applicant in order to process the application further. However, the health board has, to date, not received the requested documentation. Until the board receives the additional information, it cannot make a decision on the application.