Wednesday, 25 March 2009
Dáil Eireann Debate
112. Deputy Róisín Shortall asked the Minister for Health and Children if payments are made to general practitioners in respect of their patients who are medical card holders when the patient is admitted to long-term nursing home care; if so, the amount paid in each of the past three years for which figures are available and the rationale for making such payments; if payments are not made, the procedures in place to ensure that the Health Service Executive is notified when the patient is admitted to nursing home care and that the person is deleted from a GP’s panel; and if she will make a statement on the matter. [12377/09]
Medical card holders are entitled to retain their medical card when they move into a private nursing home. In such circumstances, the HSE must continue to make a General Practitioner (GP) service available to the patient free of charge and they retain the right to choose their own GP in the same way as if they were living in the community.
In respect of medical card holders, aged 70 years and over, who are resident in a private nursing home (approved by the HSE) for any continuous period of five weeks, the GP is currently paid a capitation rate equating to €973.99 per annum per card holder, plus a supplementary out-of-hours payment of €4.09. GPs do not generally receive a capitation fee for medical card patients in State run nursing homes.
In respect of medical card holders under 70 years of age who are resident in a private nursing home, the GP is paid an annual capitation rate in accordance with the agreed schedule of fees, depending on the cardholder’s age, gender and distance from the GP’s surgery.
The provisions of the agreement in the current GMS GP Capitation Contract in respect of medical card holders aged 70 or over take account of visits to private nursing homes being more likely to involve moderate to high dependency patients.
The other information sought by the Deputy is not provided by the HSE to my Department as a matter of routine. Accordingly, the Parliamentary Affairs Division of the Executive has been requested to arrange to address these matters and to have a reply issued directly to the Deputy.
113. Deputy Róisín Shortall asked the Minister for Health and Children if, regarding the over 70 years medical card, she will respond to reports that only a small proportion of persons believed to be over the new income threshold surrendered their medical cards; if pensioners have been given an additional month on top of the original deadline to hand back cards; if she will explain this means for those who complied with the new rules; and if they will be refunded general practitioner and medical costs to cover this extra month. [12388/09]
Minister for Health and Children (Deputy Mary Harney): Under the Health Act 2008, automatic entitlement to a medical card for persons aged 70 and over ended on 31st December 2008. With effect from 1st January 2009 the income thresholds for entitlement to a medical card for those aged 70 and over are €700 (gross) per week (€36,500 per year) for a single person and €1,400 (gross) per week (€73,000 per year) for a couple.
The Health Service Executive (HSE) wrote to all persons aged 70 years and over in January 2009. Persons who were in receipt of a medical card on a non means tested basis were requested, if over the income limits set out in the Act, to make a declaration to the Executive, on or before the 2nd March 2009. To date, 10,181 persons have returned their medical cards to the HSE and I understand that cards are still being returned.
Under the Health Act 2008, any person over the new income thresholds for the over 70s medical card is not entitled to use his / her card after March 2nd, 2009. There was no change to the deadline set out in the Act for persons to hand back their medical cards if their income exceeds the threshold. The HSE will be working with Department of Social and Family Affairs and the Office of the Revenue Commissioners on an ongoing basis to ensure that the scheme is not abused.
If a person aged 70 or over does not qualify for a medical card under the new over 70s scheme, by virtue of their gross income being over the income thresholds, the person may apply to the HSE for a medical card or GP visit card under the current medical card scheme, which allows for medical, nursing and other relevant expenses to be taken into account.
Persons who are in any way confused by the new scheme are encouraged to seek advice from their local health office which will continue to provide any necessary support, and which along with the HSE National Helpline (1850 24 1850), will handle enquiries from clients in respect of their medical card entitlements.
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