Seán Ryan
Ceist:14 Mr. S. Ryan asked the Minister for Health and Children the plans, if any, he has to provide medical cards as an entitlement to people over 65 years of age. [18887/98]
Written Answers. - Medical Cards.
Emmet Stagg
Ceist:68 Mr. Stagg asked the Minister for Health and Children his views on the future of the general medical service; his views on extending it to everybody; the costs involved if it is extended to certain groups including the over 65's in the short term; and if he will make a statement on the matter. [18883/98]
Liz McManus
Ceist:102 Ms McManus asked the Minister for Health and Children the progress, if any, made in relation to the commitment in An Action Programme for the Millennium to review medical cards for large families and the elderly; and if he will make a statement on the matter. [18991/98]
I propose to take Questions Nos. 14, 68 and 102 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 dependents 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 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, a medical card may still be awarded if the chief executive officer considers that his or her medical needs or other circumstances would justify this. It should also be noted that these guidelines are higher for persons aged 66-79 and higher again for those aged 80 and over.
In view of this special provision previous Governments did not feel it was justifiable to extend an automatic entitlement to a medical card to any specific group without any reference to their means, as a general rule. 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 dependents without hardship.
The Government identified in its programme, An Action Programme for the Millennium, the need to review the medical card eligibility for the elderly and large families. My Department has sought the views of health board chief executive officers as to how the commitment might be implemented and the implications, financial and otherwise of their proposals. My Department is currently examining the chief executive officers' response.
The estimated cost of extending medical card eligibility to those over the age of 65 is in the region of £30 million. However, this figure does not take account of the costs involved in the drugs refund scheme, DRS, attributable to people over 65 who do not currently have a medical card. This cost would have to be offset against the above figure. Since repayments on the DRS are based on expenditure by individuals or families and do not relate to the age of a person it is not possible to give an exact figure for the costs for those over 65 but it is estimated to be in the region of £4 million. Similarly costs of other health and social services which may be made available without charge to medical card holders are not included in the estimate above.
With regard to the future of the general medical service developments will aim to ensure that both the general practitioner and community pharmacy services are better organised and supported in fulfilling a more integrated role within the overall health care system in order to deliver a service which provides health and social gains consistent with the principles, set out in the health strategy, of equity, quality of service and accountability.