Dermot Ahern
Ceist:87 Mr. D. Ahern asked the Minister for Health the plans, if any, he has to introduce a tiered means system regarding eligibility for medical cards; and if he will make a statement on the matter. [5453/96]
Written Answers. - Medical Card Eligibility.
Limerick East): 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 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 and these guidelines are revised annually in line with the Consumer Price Index. 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.
The number of eligibility categories for entitlement to health services was reduced from three to two as a result of the Health (Amendment) Act, 1991. This followed the detailed analysis of the eligibility system by the Commission on Health Funding and its recommendation of measures to simplify the system and make it more equitable. In particular, the commission found that there were major problems and inequities inherent in allocating non-medical card holders to more than one eligibility category on income grounds. These problems were removed when the new eligibility system came into effect.
A tiered means system of entitlement for non-medical card holders would presumably have to be based on income and would thus reintroduce these problems. In addition, it would make the system far more complex than at present and could greatly increase administrative costs because of the increased number of persons to be means tested.
It is open to all persons to apply to the chief executive officer of the appropriate health board for health services if they are unable to provide these services for themselves and their dependants without hardship. I am satisfied that health boards give sympathetic consideration to such applications when the circumstances warrant it.