Dáil Éireann debate -
Tuesday, 24 Feb 1998

Vol. 487 No. 6

Written Answers - Health Services.

Pat Rabbitte

Question:

207 Mr. Rabbitte asked the Minister for Health and Children if he will abolish the means test for the provision of prosthesis for children; the research, if any, which takes place regarding children born with defective limbs; the reports, if any, available in this regard; if there is a register in Ireland regarding children born with defects; and if he will make a statement on the matter. [4905/98]

Minister for Health and Children (Mr. Cowen)

I presume the Deputy is refering to the means test for the medical card scheme which a person would receive prostheses free of charge.

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, 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.

The income guidelines are not statutorily binding and even though a person's income exceeds the guidelines, he or she may still be awarded a medical card if the chief executive officer considers that his/her medical needs would justify this. Medical cards may also be issued to individual family members on this basis. In view of these special provisions, I feel that it is not justifiable to extend an automatic entitlement to a medical card. It is, of course, open to all persons to apply to the chief executive officer of the appropriate health for health services if they are unable to provide these services for themselves or their dependants without hardship.

The Eurocat Register, which includes information on children born with limb defects, began operation in 1980 in the Eastern Health Board area and in Galway. Eurocat is a birth defect register using a standard approach to coding of information. It uses population based statistics and multiple sources for its database and produces reports on children born with congenital defects including limb defects. The register was extended last year to include the Southern Health Board and discussions are advanced in relation to its implementation in the North-Eastern Health Board this year. Reports are produced by the Central Eurocat Register in Brussels every two years and these show,inter alia, a comparison of limb reductions across Europe. The most recent figures indicate that while the European average for limb reduction is 6.1 children per 10,000 births, the figure in Ireland is 4.3 children per 10,000 births.

I am not aware of any research in this country regarding children born with limb defects.