Vol. 534 No. 1
33 Ms Shortall asked the Minister for Health and Children the funding provided, the arrangements made and the timeframe envisaged to extend the general medical scheme to those aged over 70 years; the discussions he has had with the Irish Medical Organisation in view of the concerns expressed by general practitioners regarding aspects of this development; and if he will make a statement on the matter. [9979/01]
The decision to extend automatic medical card eligibility to those in the age group 70 years and over was announced in the budget last December. It was also stated that the measure would be introduced from July 2001. The choice of that date was to allow for the timely, agreed and effective implementation of the initiative and, in particular, to ensure the application processes for those benefiting could be as smooth and simplified as possible.
All health boards are examining their organisational processes to ensure readiness. In addition, the Department is proposing to embark on a public information campaign at the end of April to promote awareness of the budget initiative. It is considered that a campaign at that time will have the greatest impact. That campaign will be conducted in conjunction with the health boards and involve media coverage, press releases, advertising features and even Internet promotion. Furthermore, the relevant section in my Department will continue to give the fullest information available to any person making an inquiry on the subject either now or in the future.
The budget measure was wholly consistent with the Government's overall programme of improving the position of the elderly in society both generally and specifically in relation to health services. It also represented a logical conclusion to the three year phased doubling of income eligibility limits for that category begun in 1999 and completed in March 2001.
Appropriate funding for 2001 has been made available with £4 million provided for the final phase of the doubling of the income eligibility limits and a further £7 million for the implementation of the budget provision. The money concerned is for the whole funding of this measure covering payment to all the service providers involved in providing services for medical card holders, for example, general practitioners, pharmacists, etc.
I met the Irish Medical Organisation at the beginning of March to discuss a number of issues relevant to general practice, including the introduction of automatic medical card eligibility for all persons aged 70 years and over. The discussions were both useful and informative. Prior to that meeting the Health Services Employers Agency, HSEA, had issued an invitation to the IMO to discuss the agreed implementation of the medical card extension. The IMO and Health Services Employers Agency are discussing a number of issues in regard to the GMS in general. The HSEA hopes to be in a position to respond very shortly to the IMO's issues in a manner consistent with Government pay policy and the proper long-term development of the health service. This will facilitate progress on the agreed and timely implementation of the medical card extension.
Is the Minister aware that at health board level chief executive officers have made no preparations for the extension of the GMS scheme to persons aged 70 years and over on the basis that under accountability legislation they are precluded from doing so prior to receiving consent from his Department? Does he accept that his approach to this issue has been wrong through his decision to make an announcement at budget time without having first secured dedicated funding, against the advice of his senior officials and without having received approval from the IMO? That is the reason we are in the mess in which we find ourselves with little prospect of the scheme being agreed and up and running by July.
I am somewhat surprised at the Deputy's stance. As she will be aware, budgets are matters for Governments, which take decisions.
Based on agreements.
There are no negotiations prior to a budget on proposals contained within it, which represent part of broad Government policy. That is akin to saying free travel for pensioners should be means-tested and that we should not have introduced free schemes throughout the social welfare code for those aged 70 years and over.
The Minister should not make such an announcement unless he can deliver on it.
The medical card eligibility issue was taken in tandem with all the other services the Government is providing for the elderly, particularly the over 70s. The Government is keen to do so and the budget reflected its commitment to the elderly. Additional funding was provided in the budget for this initiative.
The budget decision benefits approximately 33,000 people over the age of 70 years. Up to December 2000 approximately 251,000 aged 70 years or over had medical cards. This issue is being grossly overstated and exaggerated beyond all reason. The doubling of the eligibility threshold, to which we were committed with the final phase being introduced in March, would have added another 12,000, which would have left a balance of 33,000. A total of 1.1 million have medical cards. That is the scale of what is proposed.
The reaction to the decision has been overstated but, nonetheless, I am prepared to enter into discussions and consultations. The deadline of 1 July was set to allow us to enter into discussions with the IMO, not just on this issue, but on a range of other issues which the IMO has tabled for negotiation.
Will the Minister take on board the information I have given him that no preparations have been made in the three heath board areas in the east? My understanding is that the same position obtains throughout the country. No preparations have been made ahead of the commencement date of July because the Minister's officials will not give the go-ahead to health boards to do so.
Will the Minister comment on the question of equity, which is supposed to be a cornerstone of the heath service? How does he explain his decision, for example, to a pensioner couple aged 66 or 67 years who are only in receipt of social welfare pensions, but above the medical card threshold? In terms of equity, a millionaire aged 70 years or over is entitled to a medical card. Yet, a couple in receipt of social welfare pensions aged under 70 years are not.
