Peter Fitzpatrick (Louth, Fine Gael) | Oireachtas source

The Health (Alteration of Criteria for Eligibility) Bill 2013 seeks to reduce the income limits for medical eligibility for people over 70 and introduce new measures for data sharing between the HSE and the Department of Social Protection, as well as the HSE and the Revenue Commissioners. Overall, nearly 43% of the national population has free access to GP services under the general medical services, GMS, scheme. As of 1 February 2013, there were 1,855,797 medical cards, equating to over 40% of the national population, with 130,301 GP visit cards, representing nearly 3% of the population. Expected activity in 2013 with regard to medical cards and GP visit cards reflects a Government commitment to address rising costs in the medical card scheme and to rebalance medical cards. It also takes account of the roll-out of GP care without fees, as promised by the programme for Government. The expected total number of medical cards at the end of 2013 will be 1,921,245, with the expected total of GP visit cards at the end of 2013 at 265,257.

This Bill will reduce income limits for medical card eligibility for people over 70 to €600 per week or approximately €31,000 for a single person, or €1,200 per week or approximately €62,000 per year for a couple. Those who lose medical cards as a result of this will become eligible for a GP visit card and the HSE will also meet prescription drug costs in excess of the drugs payment scheme threshold of €144 per month. There are approximately 370,000 people over 70 in the State and approximately 360,000 medical cards issued to people over 70, giving medical card coverage of approximately 97%. In comparison, the medical card coverage of those under 70 is approximately 35%. This policy change will leave approximately 92% of the existing medical card holders over 70 unaffected, with approximately 20,000 medical card holders over 70 continuing to receive free GP services instead of a medical card.

The changes proposed in this Bill will happen in the context of a broader health service reform, including the phased introduction of free GP care for all and the introduction of universal health insurance, planned for 2016, which will effectively end the two-tier health system. The Bill allows for data sharing between the HSE and the Department of Social Protection, as well as the HSE and the Revenue Commissioners. The Bill includes provisions for sharing of personal and sensitive data between the bodies for the purpose of assessing and reviewing eligibility, entitlements and liability for taxes and charges. The Data Protection Commissioner must be consulted before data can be shared.

The legislation also proposes to change the manner in which those over 70 who have obtained separation are assessed for eligibility. Those separated over 70, although legally married, will be assessed as a single person. Their assessment will also take account of any maintenance payments. The proposed approach is similar to that used by State bodies like the Revenue Commissioners.

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