Dáil Éireann debate -
Thursday, 6 Nov 2003

Vol. 573 No. 5

Written Answers. - Medical Cards.

Róisín Shortall

Question:

146 Ms Shortall asked the Minister for Health and Children if he has satisfied himself with current medical card guidelines as they are applied to students; if he has further satisfied himself with the situation that the only circumstances whereby a student living at home can satisfy the medical criteria, apart from their parents qualifying, are those in which the student has an exact income of ?123 per week; if his attention has been drawn to the fact that for a student living with their parents to be considered independent they must prove that they have a weekly income above ?123 per week, but that the medical card income guideline for this category is also ?123 per week; his views on whether this is an entirely anomalous and unsatisfactory arrangement; and if he will change this in time for the publication of the 2004 medical card income guidelines. [26026/03]

Minister for Health and Children (Mr. Martin)

Entitlement to health services in Ireland is primarily based on residency and means rather than income. Under the Health Act, 1970, determination of eligibility for medical cards is the responsibility of the chief executive officer of the appropriate health board. Other than for persons aged 70 years and over who are automatically entitled to a medical card, medical cards are issued to persons who, in the opinion of the chief executive officer, are unable to provide general practitioner medical and surgical services for themselves and their dependants without undue hardship.

Income guidelines are drawn up by the chief executive officers to assist in the determination of a person's eligibility and these are revised annually in line with the consumer price index. However, the guidelines are not statutorily binding and even though a person's income exceeds the guidelines a medical card may still be awarded if the chief executive officer considers that his or her medical needs or other circumstances would justify this. It is open to all persons to apply to the chief executive officer of the appropriate health board for health services if they are unable to provide these services for themselves or their dependants without hardship.

Persons aged 16 to 25, including students, who are financially dependent on their parents are entitled to a medical card if their parents are medical card holders. Those who are dependants of non-medical card holders are not normally entitled to a medical card except where they have an entitlement under EU regulations or where they are in receipt of a disability allowance. Students who are financially independent of their parents are entitled to apply for a medical card in their own right and are assessed on the same criteria as all other applicants.

The decision on whether a person is regarded as a dependant or as being financially independent is made by the chief executive officer of the health board on the basis of the circumstances of each individual case. The current medical card income guideline issued by the chief executive officers of the health boards or authority for a single person, aged under 66 years who lives with family, is €123 per week. It should be remembered that health board chief executive officers have discretion in 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. 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 this.