Written Answers - Medical Cards.
Finian McGrath
Question:
33
Mr. F. McGrath
asked the
Minister for Health and Children
if a review of the eligibility for free medical care needs to be done in view of the fact that so many sectors of society that should have medical cards are discriminated against due to the fact the present criteria are too restrictive.
[6698/03]
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. Increased investment in this or any other developmental aspect of the strategy agenda is dependent on the availability of the necessary additional resources. Due to the prevailing budgetary situation I regret that it is not possible to meet this commitment this year but the Government remains committed to the introduction of the necessary changes within the lifetime of this Government.
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. Neither I nor my Department has a function in the matter. Since July 2001 all those aged 70 years or over are automatically eligible for a medical card. Health boards have discretion, in cases of exceptional need, to provide assistance for individuals where undue hardship would otherwise be caused. It should also 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 carer's 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 have been reminded by my Department that medical card holders should not be disadvantaged as a result of budgetary increases in social welfare allowances. There are a number of schemes which provide assistance towards the cost of medication for those who do not qualify for a medical card. 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 drugs payment scheme a person and his or 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. A whole series of initiatives are outlined to clarify and expand the existing arrangements for eligibility for health services. Shorter waiting times for public patients are prioritised with the expansion of bed numbers and the introduction of a 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 national anti-poverty strategy targets relating to health.
The strategy includes a whole series of initiatives to clarify and expand the existing arrangements for eligibility for health services, including recommendations arising from the review of the medical card scheme carried out by the health board chief executive officers under the PPF which include streamlining applications and improving the standardisation of the medical card applications process to ensure better fairness and transparency; providing clearer information for people about how and where to apply for medical cards; and proactively seeking out those who should have medical cards to ensure they have access to the services that are available.
The health strategy acknowledges the need to clarify and simplify eligibility arrangements. It sets down a commitment to introduce new legislation to provide for clear statutory provisions on entitlement for health and personal social services. As part of the implementation process a review of all existing legislation is ongoing in my Department. The outcome will inform the approach to the drafting of a new legislative framework on entitlements. I expect that this review will be completed in the current year and that proposals for reform will be submitted to Government.
