I propose to take Questions Nos. 51 and 80 together.
The increase in the threshold for the drugs payment scheme, the statutory outpatient charge for attendance at an accident and emergency or casualty department and the statutory inpatient charge will each take effect from 1 January 2005. The estimated saving arising from the increase in the threshold of the drugs payments scheme is €7.5 million and the additional revenue that will arise from the increases in the statutory inpatient and outpatient charges is approximately €8.5 million.
The extension of the medical card scheme, aimed at enabling an additional 30,000 persons to obtain medical card eligibility will also take effect from 1 January 2005. Subject to clarifying legislative and administrative issues, the introduction of the "doctor visit" card to enable free access to GP visits to a further 200,000 people on low income will come into effect as soon as possible in 2005. The new card is an entitlement to free GP visits for those with otherwise limited category two eligibility.
All those ordinarily resident in the State have eligibility for treatment in a public hospital, subject, in the case of those with limited eligibility, to the statutory inpatient and outpatient charge. In relation to the outpatient charge for attendance at accident and emergency or casualty departments, the charge will apply except in circumstances where the person has been referred by a medical practitioner or where the person's attendance results in admission as an inpatient. There is a number of exemptions to the statutory charges, including medical card holders with full eligibility, 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, that is, mental handicap, mental illness, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, haemophilia and cerebral palsy; holders of a Health (Amendment) Act Card: Out-patient (Amendment) Regulations 2003; persons receiving services for the diagnosis or treatment of infectious diseases prescribed under Part IV of the Health Act 1947; and members of the Defence Forces personnel and their dependants. Those holding a "doctor visit" medical card will not be exempt from the statutory charges in question unless they are covered by one of the exemptions specified above. Where exemptions do not apply, the charge may still be waived if, in the opinion of the chief executive officer of the appropriate health board, payment would cause undue hardship.
