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Dáil Éireann debate -
Wednesday, 4 Dec 2002

Vol. 558 No. 5

Priority Questions. - Medical Cards.

Willie Penrose

Question:

63 Mr. Penrose asked the Minister for Social and Family Affairs the additional resources her Department is making available to community welfare officers to deal with hardship among low income families in acquiring medical care in the wake of the Government's decision not to extend the medical card scheme to 200,000 additional people; her views on whether this is an adequate substitute for a medical card; and if she will make a statement on the matter. [24852/02]

The issue of medical cards is primarily a matter for my colleague, the Minister for Health and Children. The supplementary welfare allowance scheme, which is administered on behalf of my Department by community welfare officers employed by the health boards, is the Government's guaranteed minimum income scheme. The purpose of the scheme is to provide assistance for those who have inadequate income in order that no person in the State suffers hardship because of a lack of basic financial resources. Under the terms of the scheme, a health board may make a single payment to help meet essential, once-off, exceptional expenditure, which a person could not reasonably be expected to meet out of his or her weekly income. These payments are known as exceptional needs payments. They are made at the discretion of the health board, taking into account the requirements of the legislation and the relevant circumstances of each case.

Exceptional needs payments are not intended to be a substitute for a medical card or for any other State service and it would not be good practice to think of them in that way. In the circumstances, I do not envisage any additional role for community welfare officers in this area.

The origin of this question is that I heard a Fianna Fáil Deputy advise that it might be the way to deal with the failure of the Government to honour its commitment to give medical cards to 200,000 working class people. Is the Minister aware that this originated in a desire to assuage the deep anger and disappointment of these people, who felt betrayed by the Government reneging on its solemn commitment?

Will people who are slightly above the medical card threshold eligibility limits, which are abysmally low, and who find themselves strapped for cash and suffering hardship after having to purchase medicines and pay their GP, be assisted with a supplementary welfare allowance? Under section 266 of the 1993 Act, which outlines the grounds for entitlement to supplementary welfare allowance, would the chief executive officer of the health board be able to advise the superintendent community welfare officer that he or she could look favourably on people who might find themselves in such straitened financial circumstances and unable to pay those bills? What is the position in that regard? Would the Minister be prepared, particularly in the case of people who anticipated that they would get medical cards, which would be highly important to them from a psychological as well as a financial viewpoint, to provide an increase in the moneys available to the health boards to enable them to meet hardship payments, particularly those which might arise due to an outbreak of measles or some other disease in a family? These might not be once-off occurrences. A family might be obliged to meet these exceptional medical outlays a couple of times during the year.

It is difficult to answer a question which involves another Minister's responsibilities. The Minister indicated in the health strategy that he will continue to pursue significant improvements in medical card provision. The Deputy is correct that there is flexibility, at the discretion of the chief executive officer, to sanction the provision of a medical card where the chief executive officer considers that a person's medical needs or other circumstances justify it. That flexibility is available to deal with people with particular health or financial difficulties.

I do not envisage SWA or exceptional needs payments being used in the provision of additional State services. It would be best to approach the chief executive officer and the chief superintendent of the relevant health board to seek the exercise of his or her discretion with regard to specific needs. The exceptional needs payments are used in exceptional circumstances, such as for the purchase of exceptional commodities which people could not reasonably fund from their weekly payments.

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