Dáil Éireann díospóireacht -
Wednesday, 6 May 1998

Vol. 490 No. 5

Written Answers. - Medical Cards.

Brendan Howlin

Ceist:

209 Mr. Howlin asked the Minister for Health and Children if he will extend the medical card eligibility to cover asthma sufferers, particularly those under 18 years of age; and if he will make a statement on the matter. [10732/98]

Minister for Health and Children (Mr. Cowen)

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 have been drawn up by the chief executive officers to assist 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, 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, as a general rule, 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 has made the necessary arrangements to advance this review with the health boards.

Non-medical card holders are entitled to a broad range of health services including an entitlement to public hospital and public consultant treatment subject only to modest statutory charges and out-patient services free of charges. There are a number of schemes which provide assistance towards the cost of medication. Persons who suffer from an ongoing medical condition can avail of the drug cost subsidisation scheme which caters for those who do not have a medical card and are certified as having a medical condition with a regular and ongoing requirement for prescribed drugs and medicines. Persons who qualify for inclusion in this scheme will not have to spend more than £32 in any month on prescribed medication. Under the drugs refund scheme which covers expenditure by the whole family, any expenditure on prescribed medication above £90 in a calendar quarter is refunded by the health board.