Dáil Éireann - Volume 481 - 09 October, 1997

Written Answers. - Medical Cards.

61. Mr. Rabbitte asked the Minister for Health and Children if he will consider substantially increasing the income levels for medical cards for children under seven and for pensioners in view of the particular health needs of these categories; and if he will make a statement on the matter. [15925/97]

70. Mr. J. O'Keeffe asked the Minister for Health and Children the proposals, if any, there are to review medical card eligibility for large families and the elderly. [15771/97]

76. Mr. Stagg asked the Minister for Health and Children if he will make the necessary changes to the income guidelines for medical cards in order to exclude the elderly and large families from income means tests in view of the commitment in the Action Programme for the Millennium; and if he will make a statement on the matter. [15909/97]

Minister for Health and Children (Mr. Cowen): I propose to take Questions Nos. 61, 70 and 76 together.

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 are revised annually in line with the consumer price index. It should be noted that these guidelines are higher for persons aged 66-79 and higher again for those aged 80 and over. However, these guidelines are not statutorily binding and even though a person's income exceeds the guidelines, that person may still be awarded a medical card if the chief executive officer considers that the person's medical needs or other circumstances would justify this. Medical [616] cards may also be awarded to individual family members on this basis.

In view of this special provision it is felt that it is not justifiable, on health policy grounds, to extend an automatic entitlement to a medical card to any specific group without any reference to their means or in the case of children, to their parents' means, particularly in view of the many areas of pressing need in the health services and the limited resources available to meet them. 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.

Notwithstanding these arrangements the Government has identified as a key priority a review of medical card eligibility for the elderly and large families in An Action Programme for the Millennium and my Department is currently making the necessary arrangements to advance this review with the health boards.