Dáil Éireann díospóireacht -
Thursday, 20 Nov 1997

Vol. 483 No. 2

Written Answers. - Medical Cards.

Ivan Yates

Ceist:

13 Mr. Yates asked the Minister for Health and Children whether he will change the regulations relating to the provision of medical cards in order to provide for the automatic provision of a medical card to children who suffer handicap due to being born with limb impairment. [19820/97]

Michael Bell

Ceist:

15 Mr. Bell asked the Minister for Health and Children whether he has initiated a review of medical card guidelines as outlined in An Action Programme for the Millennium; and if he will make a statement on the matter. [16499/97]

Marian McGennis

Ceist:

85 Ms M. McGennis asked the Minister for Health and Children the consideration, if any, he has given to providing for a significant increase in the medical card eligibility limits for people aged 65 and over; and if he will provide for automatic renewal of medical cards for elderly people subject to a declaration that their circumstances are unchanged. [19810/97]

Alan Shatter

Ceist:

125 Mr. Shatter asked the Minister for Health and Children whether he will change the regulations regarding the provision of medical cards in order to provide for their automatic provision to children who suffer handicap due to being born with limb impairment. [19966/97]

Minister for Health and Children (Mr. Cowen)

I propose to take Questions Nos. 13, 15, 85 and 125 together.

Entitlement to health services in Ireland is primarily based on means. Under the Health Act, 1970, determination of eligibility for medical cards is the responsibility of the chief executive officer of the appropriate health board. Medical cards are issued to persons who, in the opinion of the chief executive officer, are unable to provide general practitioner medical and surgical services for themselves and their dependants without undue hardship.

Income guidelines are drawn up by the chief executive officers to assist in the determination of a person's eligibility and are revised annually in line with the consumer price index. It should be noted that these guidelines are higher for persons aged 66-79 and higher again for those aged 80 and over. 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. Medical cards may also be awarded to individual family members on this basis.

In the view of this special provision it is felt that it is not justifiable, on health policy grounds, to extend an automatic entitlement to a medical card to any specific group without any reference to their means or in the case of children, to their parents' means, particularly in view of the many areas of pressing need in the health services and the limited resources available to meet them. 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 or their dependants without hardship.

Notwithstanding the arrangements referred to above the Government has identified as a key priority in its programme, An Action Programme for the Millenium, a review of medical card eligibility for the elderly and large families and my Department is currently making the necessary arrangements to advance this review with the health boards.

In relation to the issue of renewal of medical cards for the elderly, the health board chief executive officers have recently reviewed their administrative procedures with a view to streamlining the renewal process to ensure that this is done in the most appropriate, efficient and cus-tomer-friendly way for various categories of applicants, including the elderly.