Brendan Howlin
Ceist:8 Mr. Howlin asked the Minister for Health if he will give an assurance that no family is deprived of access to a medical services card because of the source of their income.
Ceisteanna—Questions. Oral Answers. - Medical Cards.
Eamon Gilmore
Ceist:51 Mr. Gilmore asked the Minister for Health if he will agree to the proposal from the National Federation of Pensioners' Association to issue medical cards to persons aged between 65 and 75 who hold hospital service cards; and if he will make a statement on the matter.
I propose to take Questions Nos. 8 and 51 together.
Under the 1970 Health Act, medical cards are issued to persons who, in the opinion of the chief executive officer of the appropriate health board, are unable without undue hardship to arrange general practitioner medical and surgical services for themselves and their dependants. Income guidelines are available to assist chief executive officers in the determination of a person's eligibility but these guidelines are not statutorily binding and, even though a person's income exceeds the guidelines, that person may still be awarded a medical card if the statutory criterion which I have mentioned is met. However, the Deputies will appreciate that in assessing the merits of an individual medical card application, the chief executive officer concerned must take note of income from all sources as well as other factors such as capital available.
I can asure the House that all persons who meet the statutory requirement for entitlement to a medical card will receive one. If Deputy Howlin has a specific applicant in mind I would suggest that he write to me giving details of the particular case.
I should like to ask the Minister if he intends, as he indicated to me in the course of a reply to a parliamentary question on 1 May last, to exempt people who are in receipt of family income supplement from determination for medical card eligibility on income grounds. Will the Minister say if he intends to invoke section 45 of the Health Act, 1970, to do that and if that will disadvantage people whose incomes are identical but derived from normal working?
Yes, as announced in the budget the Government are taking steps to ensure that no person loses the medical card as a result of claiming the family income supplement.
Does the Minister find it acceptable that a person who has an income of £X derived from work plus family income supplement is entitled to a medical card while a family with the identical income from working alone is excluded from that entitlement? Will the Minister accept that is an anomaly and unfair? Does he propose to do anything about that?
It is absurd that in the case of two people on £110 per week one qualifies for a medical card and the other does not.
The Government's approach was an enlightened one. They decided to exclude the family income supplement in assessing eligibility for a medical card. If the Deputy has a case in mind and he refers the details to me I will have a look at it.
Where does justice come in?
Is the Minister aware that the National Federation of Pensioners' Associations specify that a person between the ages of 65 and 75 years who holds a hospital services card should be eligible for a medical care although he may be marginally over the limit? Will the Minister consider this issue and give full eligibility to pensioners in that category?
I am sure the Deputy is aware that special consideration is given to pensioners between the ages of 65 and 75 years in that their eligibility limit is increased by £6 and £12, respectively, for a single person and a married couple.
In the light of the Minister's indication to the House that he regards the Government's decision to treat two families with identical incomes differently as enlightened, I should like to ask him to review the scheme and revise the guidelines to health boards upwards to exclude all those covered under the new provision. All families should be treated in a like manner.
I have answered that question.
I take it that the Minister does not intend to do anything about this?
Will the Minister agree that this is another example of the anomalies that take place in the interaction between the Departments of Health and Social Welfare? Will he agree that the only answer is the introduction of a basic income scheme for all at a high enough level to enable everybody to pay for their own health services out of their own pockets? That would simplify matters.
The Deputy has raised a broader question involving a number of Departments.