Tuesday, 23 May 2000
Dáil Eireann Debate
210. Mr. N. Ahern asked the Minister for Health and Children if there is any appeal system or flexibility for persons who are issued with invoices for hospital stays and are just above the income guidelines for medical cards and cannot pay; the person or body in the Dublin area who deals with such requests; and the specific criteria for people who can expect help. [14437/00]
Minister for Health and Children (Mr. Martin): The determination of eligibility for medical cards is the responsibility of the chief executive officer of the appropriate health board. I have, therefore, referred the question to the regional chief executive officer of the Eastern Regional Health Authority and have asked him to reply directly to the Deputy.
211. Mr. N. Ahern asked the Minister for Health and Children the facilities or services provided free to parents of young children; if he will introduce free general practitioner or medical cards for all children up to (i) one year and (ii) two years in view of the high level of medical care for babies; if he will cost such a suggestion; and if he will make a statement on the matter. [14438/00]
Minister for Health and Children (Mr. Martin): 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 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.
In view of this special provision, I do not feel it justifiable, nor did previous Governments 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 as a general rule. It is, of course, 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.
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.
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