Tuesday, 27 January 2004

Questions (74)

Michael D. Higgins


187 Mr. M. Higgins asked the Minister for Health and Children the number of persons who held medical cards in June 2002 and the latest date for which figures are available; the proportion of the population this represents in respect of each such date; when it is intended to implement the commitment to extend eligibility for medical cards so as to bring in more than 200,000 extra people; the new guidelines for eligibility for medical cards, published this month; the number of additional people he estimates will qualify as a result of these changes; and if he will make a statement on the matter. [1893/04]

View answer

Written answers (Question to Minister for Health and Children)

The number of people covered by medical cards on the dates requested by the Deputy are as follows;

June 2002

December 2003

1,207,096 (30.81% of national population)

1,158,143 (29.57% of national population)

As the Deputy is aware, the health strategy includes a commitment that significant improvements will be made in the medical card income guidelines 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 its term of office.

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 CEOs, 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. It is open to all persons to apply to the CEO of the appropriate health board for health services if they are unable to provide these services for themselves or their dependants without hardship.

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 €78 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 CEOs 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 medical card income guidelines issued by the chief executive officers of the health boards for 2004 are as follows:

Medical Card Income Guidelines — Effective from 1 January 2004

Single Person Living Alone

Aged up to 65 years


Aged between 66 and 69 years


Single Person Living with Family

Aged up to 65 years


Aged between 66 and 69 years


Married Couple

Aged up to 65 years


Aged between 66 and 69 years


Aged between 70 and 79 years


Aged between 80 years and over



For child under 16 years


For dependant over 16 years with no income maintained by applicant


For outgoings on house (rent, etc.) in excess of


Reasonable expenses necessarily incurred in travelling to work in excess of


As the medical card scheme is a demand-led scheme and medical cards are issued by the CEOs on the basis of medical need to persons who are unable to arrange for their own medical needs without undue hardship, it is not possible to predict accurately the numbers of persons who will qualify for a medical card in 2004.