Vol. 513 No. 6
308 Mr. Gormley asked the Minister for Health and Children if the Government will introduce a comprehensive national health service, free to all, in view of the huge increase in revenue; and if he will make a statement on the matter. [3300/00]
The Irish health care system is structured to ensure that a high quality health care system is available to people based on need rather than ability to pay. This commitment to the principle of equity was reinforced in the national health strategy – Shaping a Healthier Future. In the context of this underlying principle of equity, it is considered that public funds can be utilised to best effect so that those who have the means to do so fund their own care or contribute to the cost of that care. The OECD publication Economic Survey of Ireland (1997) concluded that the system based on a mixture of public and private care had "resulted in good provision of health care at a relatively low cost to the tax payer".
Where people do not qualify for a medical card under income guidelines drawn up annually by health board chief executive officers, who have statutory responsibility for the determination of eligibility, a medical card may still be awarded if the chief executive officer considers that a person's medical needs or other circumstances would justify this.
Non-medical card holders are entitled, subject to certain charges, to all in-patient public hospital services in public wards including consultants services and out-patient public hospital services including consultants services. The current public hospital statutory in-patient charge is £26 in respect of each day a person is maintained, subject to a maximum payment in any 12 consecutive months of £260. Dental and routine ophthalmic and aural services are excluded from out-patient services available. However, such treatment is provided to children who have been referred from a child health clinic or a school health examination. Attendance at accident and emergency departments is subject to a charge of £25 where the patient does not have a referral note from his/her doctor. This charge applies only to the first visit in any episode of care. There are a number of exemptions from payment of these charges including women receiving services in respect of motherhood, children up to the age of six weeks, children suffering from a number of prescribed diseases and disabilities, and persons receiving services in respect of prescribed infectious diseases.
