asked the Minister for Health if he will amend health regulations to ensure that persons suffering from illness of a continuous nature will qualify for medical cards.
Ceisteanna—Questions. Oral Answers. - Medical Cards.
20.
Eligibility for medical cards is governed not by regulations but by section 45 of the Health Act, 1970. This defines an eligible person as one on whom it would be an undue hardship to provide general practitioner services for himself and his dependants. In assessing whether or not this undue hardship exists chief executive officers take account of circumstances such as illness of a continuous nature if this is brought to their attention.
Would the Minister agree that in many families a member or members may suffer from illness of a rather continuous nature and that by virtue of the fact that the family income, or the parents' income is in excess of the guidelines laid down by the health boards such members are not entitled to free medical services, the type of service provided under the medical card scheme? If the Minister so agrees, in view of the hardship imposed on any person, young or old, afflicted with an ailment which needs more or less constant care and attention over extended periods, would he not agree also that such a person should now be covered by a card? I might add in conclusion—this is not a question but a comment—that I am satisfied that the present Minister is as good a man in the House to do that by way of helping so many of those people as is any other Member. I am placing particular emphasis on this because I am a member of the Southern Health Board where I have found it useless drawing attention to these matters.
The Deputy is now making a speech; we have no time. Question No. 21.
I have much more confidence in the Minister than in the health boards. This is a big question—any boy or girl, or adult person having to go along month after month, week after week——
I have called Question No. 21.
It is a difficult question. There are a number of different aspects to it. First of all, there is the medical card itself. Even though a family or individual may be outside the guidelines nevertheless the chief executive officer has discretion to issue a medical card where the illness would be of such a nature that hardship would be caused to the family by catering for it. Secondly, there are a number of diseases which are listed as long-term illnesses and for which special provision is made.
But that is confined to three or four.
Of course since April last everybody, every individual family in the country, is entitled to participate in the drugs refund scheme. So that, as far as drugs are concerned, nobody need pay any more than £6.50 a month. That applies to everybody. I have also said to chief executive officers recently that, in the case of an individual or family having a constantly recurring heavy bill for drugs—where the amount is more or less the same going on from month to month—special arrangements should be made in these cases. There is another case, such as asthma, for instance, where again I have asked the chief medical officers to be particularly careful and to take all the circumstances of these families into account in deciding whether or not to issue a medical card. All in all, there is a fairly comprehensive approach to this problem.
I ask the Minister if he will address his comments to the West Cork health section where no such discretion is used. You are either above or below the guidelines.
Question No. 21.
A chief executive officer from the Midland Health Board is going down there now and I am sure the Deputy will be able to have a discussion on this.
(Cavan-Monaghan): Would the Minister agree that a guideline of £40 for a man and wife is very low indeed to qualify for a health card?
Like the Deputy, I would like to see it much higher, but these are the limits and the guidelines decided by the CEOs.
(Cavan-Monaghan): Would the Minister agree that it would be a hardship for anybody——
I am calling Question No. 21. The Deputy insists on ignoring the Chair and the Chair is not going to stand for that any longer.