Dan Neville
Ceist:131 Mr. Neville asked the Minister for Health and Children the plans, if any, he has to co-ordi nate the means testing of benefits in his Depart ment and in the health boards. [26268/98]
Written Answers - Health and Welfare Benefits.
Entitlement to health services in Ireland is pri marily 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, without undue hardship, to provide general practitioner medical and surgical services for themselves and their dependants. 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.
Medical cards are an entitlement to a service. The primary test is that the applicant must satisfy the board that his or her income is inadequate and that financial hardship would ensue if he or she had to make provision for certain medical ser vices. The income guidelines, therefore, 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. Medical cards may also be awarded to indi vidual family members on this basis.
A joint Department of Health and Children health board working group was established early this year to clarify the guidelines on eligibility for medical cards, particularly as they relate to the budget 1996 provision in relation to persons who have been on the live register for 12 months and who take up paid insurable employment and also to participants on approved schemes aimed at the long-term unemployed. Some difficulties and inconsistencies in the implementation of this pro vision had become apparent and the working group has addressed these. Health board chief executive officers have agreed with the recom mendations made in the report of the group and have requested that revised guidelines be pre pared. It is expected that this task will be com pleted shortly.
Entitlement to payments such as blind welfare allowance, mobility allowance and disabled per son's rehabilitation allowance are subject to a medical examination and a means test. Regu lations issued by my Department and the Depart ment of Social, Community and Family Affairs specify how entitlement should be assessed.
The Social Welfare Act, 1998, provided for a single personal public service number, public ser vice card and for the sharing of information across Government departments and specified bodies, including health boards, for the purpose of determining entitlement to benefits. This pro vision will be most helpful and will improve qual ity of service generally.
My Department is continuing to work with the health board CEOs to ensure maximum co-ordi nation of means testing in relation to the benefits for which my Department is responsible. However, the benefits involved target in some cases income maintenance and in others eligi bility for health services, for example, the medical card. These two differing objectives mean that it is very difficult to reach full co-ordination of means testing whilst still achieving the most effec tive outcome for the recipients of benefits — the primary overall objective with which I am most concerned.