Alex White (Dublin South, Labour) | Oireachtas source

I thank Deputy Ó Caoláin for raising this matter. The maintenance of health services is a priority in 2013 for the Government, despite the need for significant and challenging financial savings in the health area. Even with the extra resources made available to the Health Service Executive as part of budget 2013, just over €750 million in savings are needed during 2013. My script states €750 billion and bad and all as matters are, it is not a figure of that magnitude.

Budget 2013 set out the wide range of savings that were required and the general medical service, GMS, scheme was one of a number of areas identified. A number of steps are being taken to reduce the cost of the GMS, which costs about €2 billion per year. At the end of 2012, there were approximately 1,986,000 qualifying people under the GMS. Medical cards make up the majority of this number, amounting to about 93% of the total. As part of budget 2013, the Government has made provision for an additional 200,000 persons to be covered by the GMS. Nonetheless, it is important that we prioritise the use of scarce financial resources in the current budgetary position.

Among the budget 2013 savings measures announced was a reduction in the income limits for over 70s medical cards referred to by Deputy Ó Caoláin. It should be noted that the overwhelming majority of medical card holders aged over 70 are unaffected by that change. For the wealthiest 5% that are affected, those cardholders under the old income limits will continue to be provided with a free GP service. The Health (Alteration of Criteria for Eligibility) Act 2013 was enacted on 28 March last to give effect to the revised eligibility arrangements and the Deputy actively participated, as he always does, in the debates on the various Stages of that Bill.

Last December, at the time of the budget, it was also announced that the rules on a person's expenses that are taken into account in calculating their net income for medical card purposes would be tightened. The changes recently introduced by the HSE mean that payments on a home improvement loan and a €50 per week allowance for a car are excluded from the standard means test assessment. These changes took effect from April.

Where a decision is made by the HSE not to grant a medical card or a GP visit card, the applicant will be advised that they can request a review of the HSE decision if they believe their financial or other circumstances have not been correctly assessed. In such a circumstance the applicant may also be requested to provide any additional relevant information or details of any change in their circumstances since their original application.

To make the point clear, and Deputy Ó Caoláin clarified this correctly in the course of his contribution, the exclusion from travel to work costs relates to removing the weekly amount of €50 allowed to cover standing charges, such as depreciation or other running costs, used when considering travel to work costs as an outgoing where public transport is not available or suitable and a car is required. This means that the HSE will continue to consider the standard mileage costs or public transport costs when assessing eligibility. The Deputy will be aware that there are a broad range of allowable expenses under the means test assessment for medical cards that have not been affected by these changes.

I assure the Deputy that the changes were identified with a view to mitigating the impact on the assessment process while also yielding savings. In so doing, the new assessment arrangements continue fully to take account of a person's mortgage or rental expenses. In addition, other allowable expenses were protected in budget 2013. The need to reduce the income limits for medical cards was thereby avoided.

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