Dáil Éireann debate -
Thursday, 30 Sep 1999

Vol. 508 No. 2

Written Answers. - Medical Cards.

Michael D. Higgins

Question:

38 Mr. M. Higgins asked the Minister for Health and Children the plans, if any, he has to extend the number of chronic care patients, including asthmatics, on to the medical card; and if he will make a statement on the matter. [18242/99]

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 have been drawn up by the chief executive officers to assist in the determination of a person's eligibility and 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 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 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 parents' 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 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. Under the drug payments scheme, a person and his or her dependants does not have to pay more than £42 in any calendar month for approved prescribed drugs, medicines and appliances.