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Dáil Éireann debate -
Wednesday, 8 Nov 2000

Vol. 525 No. 3

Written Answers. - Medical Cards.

Jimmy Deenihan

Question:

226 Mr. Deenihan asked the Minister for Health and Children if he will confirm that all individuals diagnosed with cancer are automatically entitled to a medical card; and if he will make a statement on the matter. [25213/00]

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 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.

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.

The Programme for Prosperity and Fairness refers to the fact that health board chief executive officers are examining the operation of the medical card scheme and will consult with the social partners by the end of 2000. Particular emphasis will be placed on the needs of families with children, and on removing anomalies and barriers to take-up, including information deficits.

I should also mention that with effect from 1 July 1999 the drug payments scheme has been introduced. Under the drug payment scheme, a person and his/her dependants will have to pay no more than £42 in any calendar month for approved prescribed drugs, medicines and appliances.

Brendan Howlin

Question:

227 Mr. Howlin asked the Minister for Health and Children if, when treatment is actually provided after a delay of several years, there is any mechanism whereby the statutory hospital in-patient waiting charges can be waived in a case where a person has medical card eligibility at the time of placement on a waiting list for in-patient hospital treatment but is not covered by a medical card; and if he will make a statement on the matter. [25214/00]

There are no statutory hospital in-patient waiting charges. Entitlement to health services in Ireland is primarily based on residency and means, and there are two categories of eligibility. Persons in category 1 are medical card holders and they are entitled to a full range of public health services free of charge. Persons in category 2 – non-medical card holders – have limited eligibility for health services, including an entitlement to public hospital and public consultant treatment subject only to modest statutory charges.

Persons in category 1, medical card holders, are entitled to a full range of services including general practitioner services, prescribed drugs and medicines, all in-patient public hospital services in public wards including consultants' services, all out-patient public hospital services including consultants services, dental, ophthalmic and aural services and appliances and a maternity and infant care service.

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.

Persons in category 2, non-medical card holders, are entitled, subject to certain charges, to all in-patient public hospital services in public wards including consultants services and out-patient public hospital services including consultants' services. The current public hospital statutory in-patient charge is £26 per night, up to a maximum of £260 in any 12 consecutive months. Attendance at accident and emergency departments is subject to a charge of £25 where the patient does not have a referral note from his/her doctor. This charge applies only to the first visit in any episode of care. A maternity and infant care service is provided during pregnancy and up to six weeks after birth.
The charges referred to above are applied when the services required are accessed. However, the Deputy may wish to note that health boards have discretion to waive public hospital charges in cases of hardship. Application for the waiver of such fees should be made to the local health board.
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