Entitlement to health services in Ireland is primarily based on residency and means rather than income. Any person who is accepted by the health boards as being ordinarily resident in Ireland is entitled to either full eligibility – category 1, i.e. medical card holders – or limited eligibility – category 2 – for health services.
Persons in category 1 are medical card holders and are entitled to a full range of services, including all out-patient public hospital services without charge.
Persons in category 2 – non-medical card holders – are entitled, subject to certain charges, to out-patient public hospital services including consultants services. The Health (Out-Patient Charges) (Amendment) Regulations 2002 provide for a statutory charge of €40 per visit for an attendance at accident and emergency departments. This charge is levied only on persons who attend at accident and emergency departments without a referral note from their doctor and applies only for the first visit of any episode of care. Other than this charge, which refers only to visits to an A & E department, there are no other charges for public patients attending outpatient public hospital clinics.
There are a number of people who are exempt from this charge, including medical card holders, women receiving services in respect of motherhood, children up to the age of six weeks and children referred for treatment from child health clinics and school health examinations. Also exempt from these charges, in respect of treatment for the particular condition, are children suffering from prescribed diseases, i.e. mental handicap, mental illness, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, haemophilia and cerebral palsy.
Where exemptions do not apply, the charge may be waived if, in the opinion of the chief executive officer of the appropriate health board, payment would cause undue hardship. My Department has asked Mr. Michael Lyons, Chief Executive Officer, Eastern Regional Health Authority to examine the matter and to respond to the Deputy directly.