Written Answers. - Medical Cards.
Jan O'Sullivan
Question:
116
Ms O'Sullivan
asked the
Minister for Health and Children
when it is intended to implement the commitment to extend eligibility for medical cards in order to bring in over 200,000 extra people; the steps he intends to take, pending this, to meet the primary care needs of those on lower incomes who do not qualify for medical cards at present; his plans to review the very low levels of income required for eligibility; and if he will make a statement on the matter.
[3416/03]
As the Deputy will be aware the health strategy includes a commitment that significant improvements will be made in the medical card income guidelines in order to increase the number of persons on low income who are eligible for a medical card and to give priority to families with children and particularly children with a disability. However, increased investment in this or any other developmental aspect of the strategy agenda, is dependant on the availability of the necessary additional resources. Following the spending Estimates and budget adopted by the Government, this unfortunately will not be possible in 2003.
The present GMS scheme costs have increased by about 30% over the 2002 original Estimates and, on that basis, this will cost €230 million extra. Under the Health Act 1970, the determination of eligibility for health services is the responsibility of the chief executive officer of the appropriate health board and neither I nor my Department has a function in the matter. The Deputy is no doubt aware that, since July 2001, all those aged 70 years or over are automatically eligible for a medical card. I would like to add that health boards have discretion, in cases of exceptional need, to provide assistance to individuals where undue hardship would otherwise be caused.
It should be remembered that health board chief executive officers have discretion in relation to the issuing of medical cards and also that a range of income sources are excluded by the health boards when assessing medical card eligibility. Many allowances such as carers' allowance, child benefit, domiciliary care allowance, family income supplement and foster care allowance are all disregarded when determining a person's eligibility. The chief executive officers of the health boards have been reminded by my Department that medical card holders should not be disadvantaged as a result of budgetary increases in social welfare allowances.
I should also mention that for those who do not qualify for a medical card, there is a number of schemes which provide assistance towards the cost of medication. Under the long-term illness scheme, persons suffering from a number of conditions can obtain without charge the drugs and medicines for the treatment of that condition. Under the drug payments scheme, a person and his-her dependants do not have to pay more than €70 in any calendar month for approved prescribed drugs, medicines and appliances. The health strategy emphasises fairness and the objective of reducing health inequalities in our society. The area of reducing waiting times for public patients is prioritised with the expansion of bed numbers and the introduction of the national treatment purchase fund.
In addition, there are clear commitments to targeting vulnerable and disadvantaged groups including continued investment in services for people with disabilities and older people; initiatives to improve the health of Travellers, homeless people, drug misusers, asylum seekers-refugees and prisoners; and implementation of the NAPS targets relating to health. Following an extensive consultation process with disadvantaged groups carried out under the auspices of the working group on NAPS and health, NAPS health targets have been included in, Building an Inclusive Society: Review of the National Anti-Poverty Strategy, under the Programme for Prosperity and Fairness, published by the Government earlier this year.
Key health targets are to reduce the gap in premature mortality and low birth weight between the highest and lowest socioeconomic groups by 10% by 2007 and to reduce differences in life expectancy between Travellers and the rest of the population. Policy measures for implementing these targets as outlined in the Framework Document for the NAPS review and the report of the working group on NAPS and health, have been taken on board in the national health strategy.
