Michael Noonan
Ceist:199 Mr. Noonan asked the Minister for Health and Children the total full year cost of granting medical cards to all persons over 66 years of age; and if he will make a statement on the matter. [12064/00]
Written Answers. - Medical Cards.
It is not possible to state precisely the cost of extending the medical card to all persons over the age of 66 years. However, recent estimates relating to persons aged 65 years and over put the estimated cost at about £27 million. This figure does not take account of the costs of other health and social services which may be made available without charge to medical card holders. Loss of income from public hospital statutory charges, from which medical holders are exempt, would also have to be taken into account.
The Deputy will be aware that the Government identified in its programme An Action Programme for the Millennium the need to review medical card eligibility for the elderly and large families and decided that the income guidelines for entitlement to medical cards for persons aged 70 years or over should be doubled. This improvement, which is being introduced over a three year period, began on 1 March 1999. The income guidelines for those aged 70 to 79 and 80 years and over, which are already higher than the normal guidelines, increased by one third in 1999. The second stage of this process was implemented on 1 March 2000 and the third stage will be implemented in March 2001. In addition, the Programme for Prosperity and Fairness refers to the fact that health board chief executive officers are examining the operation of the medical card scheme and will consult with the social partners by the end of 2000.
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 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/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.
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 charge. There are a number of schemes which provide assistance towards the cost of medication.