Dáil Éireann - Volume 521 - 13 June, 2000

Written Answers. - Medical Cards.

210. Mr. J. O'Keeffe asked the Minister for Health and Children the total number of medical cards issued nationally for each of the past years from 1996 to 2000; the percentage of the population covered for each of those years; and if he considers the eligibility limits adequate in view of the up to date numbers. [16608/00]

Minister for Health and Children (Mr. Martin): The number of people along with the percentage of the population covered by medical cards as at 1 January 1996 to 2000 is provided in the following table:[263]






Number of persons covered






% of population covered






The Irish health care system is structured to ensure that a high quality health care system is available to people based on need rather than ability to pay. This commitment to the principle of equity was reinforced in the national health strategy, Shaping a Healthier Future. In the context of this underlying principle of equity, it is considered that public funds can be utilised to best effect where those who have the means to do so fund their own care or contribute to the cost of that care.

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 guidelines 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 would justify this. Medical cards may also be awarded to individual family members on this basis.

The Deputy will be aware that 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. Particular emphasis will be placed on the needs of families with children, and on removing anomalies and barriers to take-up, including information deficits.

It is important to note that the criteria for a medical card relate to hardship and there is no implication in the Health Act, 1970 that the number of people with a medical card should be maintained at a given percentage of the population.