Dáil Éireann díospóireacht -
Wednesday, 15 Nov 2000

Vol. 526 No. 1

Written Answers. - Medical Cards.

Róisín Shortall

Ceist:

193 Ms Shortall asked the Minister for Health and Children if his attention has been drawn to the fact that in some instances persons are being refused medical cards on review when there has been no other change of circumstances other than an increase in old age pension entitlement; if he will ensure that medical card guidelines increase at least in line with social welfare rates so that this anomaly can be avoided; if he has satisfied himself with the level of co-operation between his Department and the Department of Social, Community and Family Affairs in this regard; and if he will make a statement on the matter. [26010/00]

Minister for Health and Children (Mr. Martin)

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. 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.

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 intro duced 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.

This review is currently taking place and will be supported by an advisory group established by the chief executive officers. I am informed by the chief executive officers that consultative group meetings with the social partners, including the Department of Social Community and Family Affairs, are planned as part of this review process. Particular emphasis will be placed on removing anomalies and barriers to take-up, including information deficits.