Vol. 497 No. 1
65 Mr. G. Mitchell asked the Minister for Health and Children if he will grant medical cards to all persons on reaching age 66 without means testing and, in particular, in the case of a person (details supplied) in Dublin 6W; and if he will modify the conditions for eligibility for refunds under the drugs refund schemes in this regard. [24263/98]
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 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/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, on health policy grounds, 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 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.
Refunds under the drugs refund schemes are based on a person's requirement for, and expenditure incurred on prescribed medicines and apply equally to all citizens regardless of means or social welfare status. Persons who are certified by their general practitioner as having a long-term medical condition with a regular and on-going requirement for prescribed drugs and medicines can avail of the drug cost subsidisation scheme. Persons who qualify for inclusion in this scheme will not have to spend more than £32 in any month on prescribed mediation. Under the drugs refund scheme, which covers expenditure by the whole family, any expenditure above £90 for use in a calendar quarter is refunded by the health board.
