I propose to take Questions Nos. 23, 141 to 143, inclusive, and 145 together.
I have received correspondence from the spinal injuries action association concerning medical cards for persons with spinal injury and requesting that spinal injuries be included as a condition which would qualify under the long term illness scheme. I will deal first with the question of medical cards.
The determination of eligibility for medical cards is the responsibility of the chief executive officer of the appropriate health board. Under the Health Act, 1970, 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 provide general practitioner services for themselves and their dependants.
Income guidelines are drawn up by the chief executive officers to assist in the determination of a person's eligibility and these are revised annually in line with the Consumer Price Index. Assessment is based on gross income less PRSI deductions. However, 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 chief executive officer considers that the person's medical needs or other circumstances would justify this.