John McGuinness
Ceist:192 Mr. McGuinness asked the Minister for Health and Children if he will extend the medical card scheme to all old age pensioners; and if he will make a statement on the matter. [20666/97]
Written Answers. - Medical Cards.
Richard Bruton
Ceist:234 Mr. R. Bruton asked the Minister for Health and Children whether he has provided for an increase in the 1998 Estimate in the medical card income guidelines as they apply to elderly people and to large families; if so, if he will give details of these new provisions; and when they will come into force. [20587/97]
I propose to take Questions Nos. 192 and 234 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. Provision in the annual Estimates is not normally required when the guidelines are being indexed in this manner. It should be noted that these guidelines are higher for persons aged 66-79 and higher for those aged 80 and over. However, these guidelines are not statutorily binding and even though a person's income exceeds the guidelines, he/she may still be awarded a medical card if the chief executive officer considers that his/her medical needs or other circumstances would justify this. Medical cards may also be awarded to individual family members on this basis.
In 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.
Nothwithstanding the arrangements referred to above the Government has identified as a key priority in its programme An Action Programme for the Millennium a review of medical card eligibility for the elderly and large families and my Department is currently making the necessary arrangements to advance the review with the health boards. Since this review is not completed no provision has yet been made for it.
John Bruton
Ceist:193 Mr. J. Bruton asked the Minister for Health and Children if he will give an estimate of the cost of extending medical cards to all children born with mental and physical disabilities over and above the cost of the current provision made for these people under the long-term illness scheme. [20661/97]
Michael Creed
Ceist:195 Mr. Creed asked the Minister for Health and Children if his Department will make arrangements to ensure that persons who are in receipt of a carer's allowance will not have this income used to disqualify them from eligibility for a medical card. [20901/97]
Richard Bruton
Ceist:230 Mr. R. Bruton asked the Minister for Health and Children the cost of providing a medical card to all children who have a significant disability; and if he will make a statement on the matter. [20583/97]
I propose to take Questions Nos. 193, 195 and 230 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 officer to assist in the determination of a person's eligibility and are revised annually in line with the Consumer Price Index. When considering a person's medical card application, health boards exclude carer's allowance in assessing the applicant's income. The guidelines are not statutorily binding and even though a person's income may exceed 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 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 there services for themselves or their dependants without hardship.
In 1996, the latest full year for which figures are available, 317,069 children under 16 out of a national total of 859,424 were covered by the medical card and the average cost was £206.63. It is not possible to quantify the number of children with disability who are not already medical card holders.
However, I should mention that under the long-term illness scheme children suffering from a number of conditions including mental handicap, mental illness, cystic fibrosis, spina bifida, hydrocephalus, cerebral palsy and epilepsy can obtain without charge drugs and medicines for the treatment of that condition. In addition children suffering from a number of conditions are exempt from public hospital statutory charges.
Noel Ahern
Ceist:194 Mr. N. Ahern asked the Minister for Health and Children if he will give statistics for the number of people or couples over age 95, 90, 85 and 80 who do not have a medical card; the estimated cost of providing this service in this regard; if he will introduce an entitlement to a medical card at age 85; and if he will make a statement on the matter. [20760/97]
The level of detail requested by the Deputy in respect of those who do not have a medical card is not readily available to the General Medical Services Board. However, I can inform the Deputy that there are approximately 155,000 people over 65 years of age who are not medical card holders and it is estimated that the cost of extending eligibility to this group would cost in the region of £43 million. Furthermore, should the percentage of the population covered by medical cards reach 40 per cent, the GMS as currently structured would become subject to automatic review with the medical organisations and may entail significant additional costs which are not quantifiable in advance of negotiations.
Under the Health Act, 1970, determination of eligibility for medical cards is the responsibility of the chief executive officer of the appropriate health board who provides medical cards 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. Chief executive officers set income guidelines, which are revised annually in line with the consumer price index, to assist in the determination of a person's eligibility.
It should be noted that the income guidelines are higher for persons aged 66-79 and higher again for those aged 80 and over. However, the guidelines are not statutorily binding and even though a person's income may exceed the guidelines, he-she may still be awarded a medical card if the chief executive officer considers that his-her medical needs or other circumstances would justify this. Medical cards may also be awarded to individual family members on this basis.
In 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, 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 Millennium, 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.