Vol. 511 No. 6
253 Cecilia Keaveney asked the Minister for Health and Children his views on the expansion of the medical card eligibility to encompass all children of school going age; and if he will make a statement on the matter. [24887/99]
254 Cecilia Keaveney asked the Minister for Health and Children the costs involved in extending the medical card eligibility to encompass all children under five years; and if he will make a statement on the matter. [24889/99]
I propose to take Questions Nos. 253 and 254 together.
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 have been drawn up by the chief executive officers to assist in the determination of person's eligibility and these guidelines are revised annually in line with the consumer price index. However, the 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 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, of course, 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 is estimated that it would cost about £22.5 million to extend medical card eligibility to children under five years. However, costs of other health and social services which may be made available without charge to medical card holders are not included in the estimate above. Loss of income from public hospital statutory charges, from which medical holders are exempt, would also have to be taken into account.
