Written Answers. - Medical Cards.

Paul Bradford

Question:

122 Mr. Bradford asked the Minister for Health and Children if he will provide medical cards for all persons aged 65 and over. [25783/99]

The Government identified in its programme An Action Programme for the Millennium the need to review medical card eligibility for the elderly and large families. I am pleased to say that the Government has decided that the income guidelines for entitlement to medical cards for persons aged 70 years or over should be doubled. This improvement, which is being introduced over a three year period, began on 1 March. The income guidelines for those aged 70 to 79 and 80 years and over, which are already higher than the normal guidelines, have increased by one-third and there will be similar increases in 2000 and 2001.

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 to assist in the determination of a person's eligibility and these 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 or other circumstances would justify this.

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, 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.