Written Answers. - Medical Card Scheme.
Seán Haughey
Ceist:
163
Mr. Haughey
asked the
Minister for Health and Children
if he will review the medical card scheme to cater for residents of private nursing homes; if he will allow residents retain subsidies in relation to incontinence wear; and if he will make a statement on the matter.
[17273/00]
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 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.
As the Deputy knows, 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.
I would like to advise the Deputy that the provision of incontinence wear to persons in receipt of subvention in a nursing home is covered by the provisions of S.I. No. 227 of 1993 Nursing Homes (Subvention) Regulations, 1993, section 16.1 which state that:
A registered proprietor or person in charge shall not seek any payment in addition to the amount of the subvention determined by a health board and the contribution of the person in receipt of a subvention payable under article 13.1 of these Regulations for any service which is considered to be essential to the maintenance of a person in a nursing home and common practice in nursing homes.
Article 16.2 states that among services which are considered to be essential are bed and board, nursing care appropriate to the level of dependency of the person, incontinence wear and bedding, and aids and appliances necessary to assist a dependent person with the activities of daily living.
