Dáil Éireann Debate, Wednesday - 16 June 2004
176 Ms McManus asked the Minister for Health and Children if he will publish the criteria used in deciding whether children with a long-term serious condition can obtain a personal medical card; if he will consider extending the medical card as of right to such children; and if he will make a statement on the matter. [18059/04]
Amharc ar fhreagraEntitlement to health services in Ireland is primarily based on residency and 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. Other than for persons aged 70 years and over who are automatically entitled to a medical card, 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/or their dependants, such as seriously ill children, without undue hardship. Details of the medical card scheme, and other public health care entitlements, are published on my Department's website, and on the Government Oasis website. They are also available from each health board.
Income guidelines are drawn up each year by the health board-authority chief executive officers to assist in the determination of a person's eligibility for a medical card and these are revised annually in line with the consumer price index, CPI. However, it should be noted that 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. 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.
For those who do not qualify for a medical card there are a number of schemes which provide assistance towards the cost of medication. Under the 1970 Health Act, a health board may arrange for the supply, without charge, of drugs, medicines and medical and surgical appliances to people with a specified condition for the treatment of that condition under the long term illness, LTI, scheme. The conditions are: mental handicap, mental illness — for people under 16 only, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, diabetes mellitus, diabetes insipidus, haemophilia, cerebral palsy, epilepsy, multiple sclerosis, muscular dystrophies, parkinsonism, conditions arising from thalidomide and acute leukaemia. A person with an eligible condition, or their parent, should contact their local health board in order to register under the scheme. Under the drug payment scheme, a person and his or her dependants will not have to pay more than €78 in any calendar month for approved prescribed drugs, medicines and appliances.
It should be remembered that health board chief executive officers have discretion in relation to the issuing of medical cards and also that a range of income sources are excluded by the health boards when assessing medical card eligibility. Many allowances such as carer's allowance, child benefit, domiciliary care allowance, family income supplement and foster care allowance are all disregarded when determining a person's eligibility. Given these factors and the discretionary powers of the CEOs, having an income that exceeds the guidelines does not mean that a person will not be eligible for a medical card, and a medical card may still be awarded if the chief executive officer considers that a person's medical needs or other circumstances would justify that.
