Dáil Éireann - Volume 494 - 01 October, 1998

Written Answers - Medical Cards.

226. Mr. Bradford asked the Minister for Health and Children the plans, if any, he has to make provision for the granting of a medical card to all citizens over the age of 65. [18261/98]

Minister for Health and Children (Mr. Cowen): 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 have been drawn up by the chief executive officers to assist in the determination of a person's eligibility and these are revised annually in line with the consumer price index. However these 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 should also be noted that these guidelines are higher for persons aged 66-79 and higher again for those aged 80 and over.

In view of this special provision previous Governments did not feel it was justifiable, 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, 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. [889] Notwithstanding the arrangements referred to above the Government has identified as a key priority in its programme An Action Programme for the Millennium, a review of medical card eligibility for the elderly and large families. My Department has sought the views of health board chief executive officers as to how the commitment might be implemented and the implications, financial and otherwise of their proposals. Their response is currently being considered by my Department.