Dáil Éireann Debate, Tuesday - 24 October 2006
420 Mr. Connolly asked the Minister for Health and Children her views on the extremely low uptake of the doctor only medical cards; if she proposes to restore the full medical cards that have been revoked from holders; and if she will make a statement on the matter. [34595/06]
View answerThe GP visit card initiative was introduced as a graduated benefit so that people on moderate incomes, particularly parents of young children, who do not qualify for a medical card would not be deterred on cost grounds from visiting their GP. The Health Service Executive (HSE) began to issue GP visit cards in November, 2005 and thus the GP visit card has been available for less than a year. Information supplied to my Department by the HSE indicates that as at 20 October 2006 there were 40,059 persons holding a GP visit card. In relation to the Government commitment to provide an additional 30,000 medical cards this has been exceeded. As of 1st October, 2006, 1,209,284 persons hold a medical card which is an increase of 64,201 card holders from January 2005 (1,145,083).
The assessment of eligibility for medical cards and GP visit cards is statutorily a matter for the HSE and is determined following an examination of the means of the applicant and his/her dependants. Under Section 45 of the Health Act 1970 medical cards are provided for persons, who in the opinion of the HSE, are unable without undue hardship to arrange general practitioner medical and surgical services for themselves and their dependants. Section 58 of the Health Act, 1970, as amended, provides for GP visit cards for adult persons with limited eligibility for whom, in the opinion of the HSE, and notwithstanding that they do not qualify for a medical card, it would be unduly burdensome to arrange GP medical and surgical services for themselves and their dependants. Persons aged 70 and over are statutorily entitled to a medical card, regardless of income.
The income guidelines used by the Executive for the purpose of assessing eligibility to medical cards and GP visit cards are not statutorily binding. Medical cards and GP visit cards may be granted by the HSE to persons in circumstances where the income guidelines are exceeded but the particular circumstances of the case warrant such a decision. Decisions to refuse an application or renewal of a medical card or GP visit card may, of course, be appealed to the Executive for further consideration. In cases where the applicant does not qualify for the medical card, they are then automatically assessed to see if they qualify for a GP visit card. The assessment guidelines also provide that where an applicants weekly income is derived solely from Social Welfare or HSE allowances/payments, a medical card will be granted.
In 2005 significant changes were made to make it easier for people to qualify for a medical card or a GP visit card. The income guidelines used to assess eligibility were increased by a cumulative 29%. A higher rate of increase was applied to the income allowances for children and was specifically aimed at assisting low income families. Also, the assessment of means is now based on income after tax and PRSI and full account is taken of reasonable expenses in respect of rent/mortgage payments, childcare and travel to work which has the effect of further reducing the threshold at which a person would qualify for the medical card or the GP visit card. In June 2006 I agreed with the HSE a further adjustment to the income assessment guidelines used for GP visit cards and these are now 50% higher than those used for medical cards.
Since the introduction of the GP visit card, the HSE has conducted two national media advertising campaigns to promote the benefit. The Executive continue to publicise all of the changes to encourage people to apply and has made the application process as simple as possible.
I believe that the substantial increases which have been made to the income guidelines in respect of both the medical card and GP visit card, allied with the HSE's campaign to encourage people to apply, ensures that the most vulnerable people in our society have free access to GP services.
