Dáil Éireann Debate, Thursday - 28 October 2004
126 Mr. R. Bruton asked the Tánaiste and Minister for Health and Children the basis on which certain EU country pensioners enjoy entitlement to a medical card without a means test; if she will consider extending similar provisions to Irish persons who are suffering from a specified list of serious illnesses; and if she will make a statement on the matter. [26486/04]
Amharc ar fhreagraOn joining the EU, the arrangements for the co-ordination of Ireland's social security system, including health care benefits, with those of the other member states were agreed under the terms of EU Regulation 1408/71. As a consequence of these arrangements, persons taking up permanent residence in Ireland who are in receipt of a social security pension from another EU member state but not in receipt of an Irish Department of Social, Community and Family Affairs pension as a recipient or dependant and who cannot be regarded as employed or self-employed in Ireland, are entitled to receive health services free of charge and are issued with a medical card. The full costs associated with the provision of health care for such persons under the regulations are met by the country of origin.
Where the EC regulations do not apply, persons with social security pensions from another EC member state are entitled to be assessed for medical cards by the chief executive officers of the health board under the normal eligibility criteria. Entitlement 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. Apart from persons aged 70 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.
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. However, the guidelines are not statutorily binding and, even though a person's income may exceed 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.
A number of schemes provide assistance towards the cost of medication for those who do not qualify for a medical card. 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 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-her dependants will not have to pay more than €78 in a calendar month for approved prescribed drugs, medicines and appliances.
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 be ineligible 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 this.
