I propose to take Questions Nos. 256 and 271 together.
Entitlement to health services in Ireland is primarily based on means. Unlike 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 have been drawn up by the chief executive officers to assist in the determination of a person's eligibility and these 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, a medical card may still be awarded if the chief executive officer considers that his/her 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 I do not feel it justifiable, nor did previous Governments, on health policy grounds, 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, as a general rule. 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.
Non-medical card holders are entitled to a broad range of health services including an entitlement to public hospital and public consultant treatment subject only to modest statutory charges and out-patient services free of charge. There are a number of schemes which provide assistance towards the cost of medication.
As medical cards are granted based, in general, on means rather than medical condition health boards do not hold information on the number of medical card holders with particular illnesses.