Margaret Conlon (Cavan-Monaghan, Fianna Fail)

I will share time with Deputy Beverley Flynn.

I thank the Ceann Comhairle for affording me an opportunity to contribute on Second Stage of the Health Bill 2008. The issue of medical cards for elderly people has been most emotive, with many people fearing that all medical cards would be taken from those aged over 70 years. Such a step was never intended. Hearing people from my parents' generation cry, worried and fearful, on radio shows made for tough listening. The real fear of many people was on display at the protest on Kildare Street following the budget. However, I am reminded of how quickly times change given that in 2001 Opposition Deputies had no appetite for the introduction of medical cards for those aged 70 years and over.

Under the new system, the Health Service Executive will write to all medical card holders aged 70 years and over informing them about the new arrangements. People whose income is below the new threshold will keep their cards and continue to use them as normal. Only those whose incomes are above the threshold will be required to notify the HSE. If a person's income is below the limits, he or she will not have to wait on a letter to arrive and should not be worried or fearful. Such persons can rest assured they will keep the medical card. This vital information, which was lost in the debate, needs to be reiterated.

The new income thresholds are designed to ensure that the vast majority of people aged 70 years and over will continue to have a medical card and only those on higher incomes will lose their entitlement. The new income thresholds announced by the Government for persons aged 70 years and over mean that from 1 January 2009 onwards, retired Ministers, Ministers of State, judges and Secretaries General of Government Departments, to name but a few, will no longer qualify for a medical card. Should such individuals receive a medical card? Individuals in these groups earned enough money in their working lives. Medical cards would be better placed in the hands of ordinary men and women who earned a modest wage during their career or do not have a substantial pension.

Deputy Jan O'Sullivan asked the reason gross income is used as the threshold. Income is any earning a person receives in the form of a pension or through investments or savings. Under the scheme, gross income is assessed, that is, income before tax or other deductions. It is much easier to identify what is one's gross income. The new gross income thresholds are well in excess of the net limits of €360 and €720 for a single person and couple, respectively. Previously, those whose income was less than these thresholds would only have qualified for a GP visit card.

It should also be noted that only the interest earned on savings is counted as income, while income from savings up to the first €36,000 for a single person and €72,000 for a couple is not counted. However, those whose income is over the threshold may still receive a medical card if their personal or health circumstances cause them undue financial hardship. In the event that one partner is aged 70 years, both partners will qualify for a medical card if their income is less than €1,400 per week. In addition, the current HSE appeals mechanism will continue to apply.

There will always be pressing demands on scarce national resources. It would be a wonderful world if everyone received free medical care but unfortunately we do not live in such a utopia.

See this speech in context