Dáil Éireann Debate, Wednesday - 7 July 2004
243 Cecilia Keaveney asked the Minister for Health and Children the plans to bring in a tier medical card system and or review income limits for medical cards; and if he will make a statement on the matter. [20749/04]
View answerEntitlement to health services in Ireland is primarily based on residency and means. 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 eligible for 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. For those who do not qualify for a medical card there are a number of schemes which provide assistance towards the cost of medication, including the long-term illness scheme and the drug payments scheme. Many allowances such as carers' allowance, child benefit, domiciliary care allowance, family income supplement and foster care allowance are 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 any 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 if they are unable to provide health services for themselves or their dependants without hardship.
There is no short-term plan to extend medical card income guidelines other than as provided for by the annual CPI index increase. The last such increase was notified in January 2004. However, in line with the health strategy entitled Quality and Fairness — A Health System For You, the possibility of extending medical card entitlement by statute to various groups is under ongoing review in my Department in the context of the strategy's second goal which is fair access. 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.
The health 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.
In addition, my Department is committed to the preparation of new legislation to update and codify the whole legal framework for eligibility and entitlements in regard to health services.
