Under the Health Act, 1970, the determination of eligibility for medical cards is the responsibility of the chief executive officers of the appropriate health board. Medical cards are issued to persons who, in the opinion of the chief executive officer, are unble to provide general practitioner medical and surgical services for themselves and their dependants without undue hardship.
Arrangements have been agreed with the chief executive officers to enable persons who have been unemployed for at least one year to retain their medical cards for three years after entering employment. These arrangements also cover participants on the schemes applicable to the long-term unemployed. The intention of the measure is to facilitate the return to employment of those on the live register who previously would have been reluctant to do so, on the basis that they could lose their medical card entitlement and therefore could end up being worse off having taken up employment.
I have had inquiries made of the Eastern Health Board concerning the case raised by the Deputy and have been informed that as the person in question had not been continuously unemployed for one year prior to taking up employment, the above arrangements would not apply. As the applicant's income is over the standard income guidelines used to assist determine eligibility, the health board has requested details of the person's medical expenses in order to consider the application on medical grounds.
Given the statutory function of the chief executive officers of the health boards in determining medical card eligibility, and as the eligibility of persons taking up employment may change, it is appropriate that the eligibility of such persons be reviewed whenever this arises.
Every person who is in genuine need of a medical card must of course receive one and I am satisfied that health boards give sympathetic consideration to applications made on the grounds of special medical need when the circumstances warrant it. I am also satisfied that the arrangements outlined above address the perceived disincentive which previously could have prevented the long-term unemployed from taking up employment.
