I propose to take Questions Nos. 191 and 192 together.
The Government is fully committed to the extension of medical card coverage as set out in the health strategy. This will focus on people on low incomes. The timing of the introduction of the extension will be decided having regard to the prevailing budgetary position.
Income guidelines are drawn up each year by the health board-authority chief executive officers to assist in the determination of a person's eligibility for a medical card and these are revised annually in line with the consumer price index, CPI. The last such increase was notified in January 2004. For those who do not qualify for a medical card there is a number of schemes that provide assistance towards the cost of medication. Under the long-term illness scheme persons suffering from a number of conditions can obtain the drugs and medicines required for the treatment of that condition free of charges. The conditions in question include intellectual disability. Under the drug payments scheme, a person and his or her dependants will not have to pay more than €78 in any calendar month for approved prescribed drugs and medicines.
Health board chief executive officers have discretion in relation to the issuing of medical cards and a range of income sources are excluded by the health boards when assessing medical card eligibility. Despite someone having an income that exceeds the guidelines, 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 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.
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.