Malcolm Noonan (Carlow-Kilkenny, Green Party) | Oireachtas source

Ba mhaith liom buíochas a ghabháil leis an Teachta as ucht an cheist seo a cur. Eligibility for a medical card is primarily based on a financial assessment, which is conducted by the HSE in accordance with the Health Act 1970. The HSE assesses each medical card application on a qualifying financial threshold. This is the amount of money that an individual can earn per week and still qualify for a card. It is specific to the individual’s financial circumstances. As of 1 April, almost 1.6 million people hold eligibility for a medical card and 660,487 hold eligibility for a GP visit card.

Persons aged 69 years and under are assessed under the general means-tested medical card thresholds, which are based on an applicant’s household income after tax, PRSI and the universal social charge. Certain expenses are also taken into account. Examples of allowable expenses include rent, mortgage, certain insurance costs, childcare, maintenance and net nursing home costs, which help to increase the amount a person can earn and still qualify for a medical card. Some social welfare payments, for example, child benefit, fuel allowance, etc., are also exempt from medical card income assessment.

In this context, there is an existing increase for living on a specified island, which is sometimes called the island allowance or island increase. The Deputy will be familiar with it. This is intended to compensate for those extra costs of living on an island off the coast of Ireland. The Deputy may wish to note that the island allowance is also exempt from assessment when applying for a medical card.

Every effort is made by the HSE, within the framework of the legislation, to support applicants in applying for a medical card and, in particular, to take full account of the difficult circumstances in the case of applicants who may be in excess of the income guidelines. The HSE may exercise discretion and grant a medical card even though an applicant exceeds the income threshold where he or she faces difficult financial circumstances, such as extra costs arising from an illness. Social and medical issues are also considered when determining whether undue hardship exists for an individual accessing general practitioner or other medical services.

The Minister for Health assures the Deputy that, in order to ensure the medical card system is responsive and sensitive to people's needs, his Department keeps medical card issues under review and any proposals are considered in the context of potential broader implications for Government policy, the annual budgetary Estimates process and legislative requirements arising.

I note the pertinent points the Deputy made about the additional costs that islanders face. Living on islands is something that the Government wants to encourage and support in order to keep as many families on the islands as possible and to keep our islands alive and vibrant into the future.

See this speech in context