I propose to take Questions Nos. 205, 206 and 218 together.
The Health Act 2004 provided for the Health Service Executive, which was established on 1 January 2005. Under the Act, the executive has the responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. This includes responsibility for the assessment for medical cards.
The new income guidelines, as agreed by the chief executive officers of the former health boards, have been introduced since January 2005. These guidelines reflect the 7.5% increase on the 2004 figures, as announced by me in November 2004, and also include substantial increases in respect of dependent children. Parents of children with illnesses that persist from year to year can be assured that they will not have to reapply for a medical card each year alleviating the anxiety of wondering if their medical card will continue. The assumption is that this will apply to a small number of children with very serious illnesses, where a review would normally result in automatic renewal of the medical card. An operational group overseeing the medical card scheme has been asked to put processes in place that limit the need for frequent reviews in these cases.
The procedures and arrangements in place locally in respect of the administration of the general medical services scheme are matters for the chief officer of the Health Service Executive's area to decide. This would include the issue of reviews of eligibility of card holders and the frequency of such reviews.
An estimated 70,000 discretionary medical cards reflect the number of cards in the system. This figure is based on data from the former health boards. These cards were issued under the discretionary powers of the chief executive officers under the Health Act 1970. The Health Service Executive is addressing, in conjunction with my Department, the drawing up of guidelines governing the issue of discretionary medical cards.