Dáil Éireann díospóireacht -
Thursday, 19 Nov 1998

Vol. 497 No. 1

Written Answers. - Medical Cards.

Denis Naughten

Ceist:

61 Mr. Naughten asked the Minister for Health and Children the plans, if any, he has to increase medical card cut off guidelines due to the current hardship being experienced by a number of people who are being refused medical cards for being £2 or £3 over the income limit; and if he will make a statement on the matter. [24228/98]

Denis Naughten

Ceist:

62 Mr. Naughten asked the Minister for Health and Children the plans, if any, he has to review medical card income guidelines in view of the fact that many people on low incomes are now ineligible for medical cards due to the low cut off points; and if he will make a statement on the matter. [24229/98]

Minister for Health and Children (Mr. Cowen)

I propose to take Questions Nos. 61 and 62 together.

Entitlement to health services in Ireland is primarily based on means and the legal responsibility, under the Health Act, 1970, for the determination of eligibility for medical cards is with the chief executive officer of the appropriate health board. Medical cards are issued to those 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 these guidelines are revised annually in line with the consumer price index. However, the 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/her medical needs would justify this. 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.

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 is continuing to have discussions with the health board chief executive officers regarding their views on these issues. I expect to make a decision about these matters shortly.

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 on-going 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 on-going 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.