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Dáil Éireann díospóireacht -
Wednesday, 17 May 1978

Vol. 306 No. 8

Ceisteanna—Questions . Oral Answers . - Health Services Eligibility .

14.

asked the Minister for Health the total costs, in all its aspects, of administering the various permutations of the means test for determining eligibility for the health services.

: It would be difficult to quantify these costs as they fall on a large number of agencies and concerns.

: Is this not one of the great points against the kind of service in which the Minister believes, the multiplicity of eligibility criteria? Is it not the job of a responsible Minister, before he recommends to Parliament a particular kind of service, to know the financial implication of that kind of service, the means test one, which was a very important criterion for me in relation to whether or not I would have a means type test service and for most people concerned? Is the Minister not interested in the fact that the implementation of the various limited eligibility clauses would be a very costly procedure in administrative terms?

: I do not think it is fair for the Deputy to say I am not interested.

: Interested enough to find out.

: The general position is that I hope to effect a very considerable improvement in this whole area with the introduction of the pay-related scheme next April. However, the Deputy should bear in mind that selectivity in the administration of the health services is thought desirable by many people. In fact, I think the socialist viewpoint in recent years was very much adherence to the idea of selectivity and, of course, selectivity means a means test.

: Would the Minister not agree that, if he is proposing to improve the administration of the health service, he knows it has to be improved? Why would he improve a service which is all right? Does he know whether it is all right? How can he know that unless he assesses it?

: I know that on the question of eligibility for health services generally the situation is not satisfactory. I admit that, but I hope to effect a considerable improvement next April with the introduction of the pay-related insurance and health contribution. I must repeat to the Deputy that in this area the arguments for and against selectivity based on a means test are open and shut. If I have limited resources and I can introduce improvements on the basis of selectivity only, surely I should bring them in for people most in need of them even if it involves selectivity and a means test.

: What about the wealth tax?

: Would the Minister not agree that the only reason he considers he has limited resources is that the limited resources are restricted to a minority of the population and if there were proper distribution of wealth in this society there would be plenty of money to go around?

: We are having argument now which does not arise.

: Some day the Deputy and I may agree on all these fundamental matters.

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