Written Answers. - Medical Cards.
Willie Penrose
Question:
120
Mr. Penrose
asked the
Minister for Health and Children
when it is intended to implement the commitment to extend eligibility for medical cards 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; his plans to review the very low levels of income required for eligibility; and if he will make a statement on the matter.
[17553/03]
Liz McManus
Question:
293
Ms McManus
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.
[17790/03]
I propose to take Questions Nos. 120 and 293 together.
As the Deputy is 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. This should be viewed in the broader context of the strategy's emphasis on fairness and its stated objective of reducing health inequalities in our society. 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.
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. Given these factors and the discretionary powers of the chief executive officers, having an income that exceeds the guidelines does not mean that a person will not be eligible for a medical card, and a medical card may still be awarded if the chief executive officer considers that a person's medical needs or other circumstances would justify that.
Non-medical card holders, and people with conditions not covered under the long-term illness scheme, can avail of the drugs payment scheme. Under this scheme, no individual or family unit pays more than €70 per calendar month towards the cost of approved prescribed medicines.
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 to 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 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 is 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/refuges and prisoners; and implementation of the NAPS targets relating to health.
Access to primary care services is of crucial concern to this Government as is evidenced by the publication of a separate strategy document, Primary Care: A New Direction. Primary care is the first port of call for the majority of people who use health services. It can meet 90% to 95% of all health and personal social service needs. It is a vital public service.
The primary care strategy sets out a vision of the service we want to put in place, building on our existing strengths to develop a high quality, user-friendly primary care service to meet people's needs into the future. However, change will not be effected overnight. The strategy sets out an implementation plan, which recognises the breadth of the change, which will be required in order to support the rolling-out of the new primary care model over the next decade.
As the new model is developed, a wider primary care network of other primary care professionals will also provide services for the population served by each primary care team. Last year I approved the establishment of a number of initial implementation projects, which will involve putting in place an integrated primary care team in ten locations around the country. This will enable us to see, in a real and practical way, how the new model will operate in practice, the benefits which we hope will flow from this new way of working and to explore some of the implementation issues in a practical way.
This is only one of the first steps along the way. The implementation period recognises that there are major structural changes which must occur in order for the new primary care model to be implemented. It is also necessary to ensure that the required numbers of health professionals are trained and retained in the system over the coming decade and beyond to meet anticipated needs. One of the principal objectives of the plans for the modernisation of our health service structures which I have recently announced is that the system should be structured to enable the health strategy, including the primary care strategy, to be delivered. As part of the reform plans, therefore, the system for the planning and delivery of primary care services at national, regional and local level will be reorganised in line with the vision contained in the primary care strategy.
The targets to reduce health inequalities set out in the Government's review of the national anti-poverty strategy and which were developed in the course of an extensive consultation process have been integrated into the national health strategy. Key health targets are to reduce the gap in premature mortality and low birth weight between the highest and lowest socio-economic 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. Because of the wide range of factors which affect health status and health inequalities, the national health strategy envisages these targets being met through a range of actions including greater focus on multi-sectoral work and health impact assessment.
