Vol. 510 No. 5
70 Mr. J. O'Keeffe asked the Minister for Health and Children if EU pensioners living in Ireland are entitled to medical cards without a means test; and the proposals, if any, he has to extend similar cover to the elderly in Ireland. [22393/99]
Arrangements under EU regulations supersede the provisions of the Irish eligibility system in respect of certain categories of nationals of other EU states. Where this situation arises, health boards are obliged to provide health services, on the same basis as medical card holders, for these people on behalf of their home state, which retains responsibility for the costs involved in the provision of the services.
As a result pensioners in receipt of social security pensions from other EU states who are ordinarily resident in Ireland, not covered by an Irish social welfare pension, as recipient or dependant, and who are not employed or self-employed here, are entitled to receive health services free of charge and are normally issued with a medical card.
Entitlement to health services in Ireland is primarily based on residency and means. Any person, regardless of nationality, who is accepted by the health boards as being ordinarily resident in Ireland is entitled to either full eligibility, that is medical card holders, or limited eligibility for health services. Health boards normally regard a person as "ordinarily resident" if he or she satisfies the health board that it is his or her intention to remain in Ireland for a minimum period of one year.
Income guidelines are 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, 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 or her medical needs or other circumstances would justify this.
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. 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.
