Written Answers. - Medical Cards.
John McGuinness
Ceist:
241
Mr. McGuinness
asked the
Minister for Health and Children
the plans, if any, he has to review the medical card system to allow a medical card to be issued for life to disabled persons in their own right; and if he will make a statement on the matter.
[14989/99]
David Stanton
Ceist:
248
Mr. Stanton
asked the
Minister for Health and Children
the reason persons suffering from mental illness, particularly long-term mental illness, have to make a fresh application for medical card entitlement each year; if he will grant certain categories of these people an entitlement to a medical card for life; if he will extend the time requirement to others to at least five years; and if he will make a statement on the matter.
[15020/99]
I propose to take Questions Nos. 241 and 248 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 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. Medical cards may also be awarded to individual family members on this basis.
In view of this special provision I do not feel it justifiable, nor did previous Governments, 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.
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. I should also mention that for those who do not qualify for a medical card there are a number of schemes which provide assistance towards the cost of medication. Under the long-term illness scheme operated by health boards, persons suffering from a number of conditions, including mental handicap, mental illness, for persons under 16 only, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, diabetes mellitus, diabetes insipidus, haemophilia, cerebral palsy, epilepsy, multiple sclerosis, muscular dystrophies, parkinsonism and acute leukaemia can obtain without charge, the prescribed drugs and medicines for the treatment of that condition.
Persons who suffer from an on-going medical condition can avail of the drug cost subsidisation scheme. Any person who qualifies 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.
With effect from July 1999 the drug payments scheme is being introduced which will replace the drug refund scheme and the drug cost subsidisation scheme. Under the drug payment scheme, a person or his or her dependants will not have to pay more than £42 in any calendar month for approved prescribed drugs, medicines and appliances for use by that person or his or her dependants in that month. In addition, children receiving treatment for mental handicap, mental illness, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, haemophilia or cerebral palsy are exempt from public hospital statutory charges.
Assessment procedures are also a matter for the chief executive officer of the health boards. Medical cards are usually granted to persons for a period of 12 months only as a person's entitlement may change, for example, due to taking up employment. A medical card holder must also inform his-her local health board office if his-her circumstances have changed while his-her card is still valid.
It is of course 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.
