Jan O'Sullivan (Limerick East, Labour)
Link to this: Individually | In context

I welcome the opportunity to raise this issue which has pretty much occupied the minds of everybody in this country for the past 24 hours. With all due respect to the Minister of State, Deputy Barry Andrews, I am disappointed that the Minister for Health and Children is not in the House to respond to this issue. We have seen panic measures throughout the country concerning the Government's response. The HSE's website has changed its position three times in the course of the day in terms of what the income limits might be. While it may change again tomorrow, the latest position is that they have now raised the limit for single people by approximately €40 and by a little bit more for a married couple. It is clearly a panic measure in response to the outrage of elderly people throughout the country who have been phoning us all day and speaking on the airwaves. These people have given their life's work to the country and have paid their taxes when taxes were high. They were given medical cards in 2001 prior to the 2002 general election, which was clearly a ploy to win that election, but they now learn that their cards will be withdrawn. Those people do not need any lectures on patriotism from anyone in the Government, including the Minister for Finance. They know what it is to be patriotic. They were told that the weak would not have to pay for the problems the Government has led us into. Clearly, however, the weak have paid. The very people who devoted their lives to this country and who now require medical care in their later years, will have their medical cards taken away.

In last night's debate, I pointed out that the income threshold for a couple — where one was under 70 and the other over 70 — had been halved by the stroke of a pen in this budget. The threshold has been slightly raised today as a result of the furore it caused. I urge the Government to go back to the drawing board on this measure. It is not over by any means. There may be a feeling in Government circles that because this panic measure was taken it will appease people somehow or other, but it will not. Many people remain outside the limits and will suffer hardship as they will not be able to pay for their medical needs. As a result they will be in poorer health.

Studies have shown that the removal of the means test improved circumstances for a considerable number of people, as well as improving health outcomes. It provided access to flu vaccinations and community-based therapies. A doctor-only medical card will not provide the kind of holistic care elderly people require if they are to remain in the community. It is meant to be Government policy to encourage people to stay in the community, rather than going into institutional care or hospital. This measure will turn the situation around completely, however.

I strongly urge the Government to re-examine this matter. It should renegotiate the issue with the Irish Medical Organisation because doctors were paid a hugely inflated amount of money. The decision was announced before negotiations were completed, purely to win the votes of those who, as the Government knew at the time, are the kind of people who actually go out to vote. Those people are outraged and feel let down. They feel they have not been respected or cared for. They will not accept this measure which is a mealy-mouthed effort to appease them.

Many items in the budget have caused concern by inflicting damage on the poor, particularly the working poor. However, of all the budgetary measures, this one concerning medical cards is truly the harshest and most uncaring. It simply needs to be withdrawn. While he is not directly responsible, I urge the Minister of State and his colleagues in the three Government parties to go back to the drawing board. The Minister for Social and Family Affairs, who is a constituency colleague of the Minister of State, will have to amend the Social Welfare Bill. It will not require the Minister for Health and Children to amend the Health (Miscellaneous Provisions) Act 2001, but does concern the Social Welfare Bill. There will be major opposition to this measure, which is unfair because it attacks those whom we should protect. They have devoted their lives to the country and are particularly outraged by the call to patriotism, which was made on the same day at this blow was struck against them.

Barry Andrews (Dún Laoghaire, Fianna Fail)
Link to this: Individually | In context

I thank Deputy Jan O'Sullivan for raising this Adjournment matter, which I take on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney.

In the budget, the Government decided to end the automatic entitlement to a medical card for persons aged 70 and over, with effect from 1 January 2009. This was done to ensure that public health funding is used to help those most in need. Some people have a medical card as a result of a means test, while others received a medical card automatically, without a means test, when they turned 70.

I wish to clarify the following points. Any person with a medical card as a result of a means test is not affected by this decision, irrespective of age, what means test the person did or when they did it. Their medical card benefits are not affected. They will not now be asked to do a new means test, nor will they be written to by the HSE as a result of the budget decision.

For any person aged 70 or over who got a medical card without a means test, the budget decision is important because their present medical card will expire on 31 December this year. The HSE will write to them between 31 October and 14 November asking them to complete a simple means test to decide the benefits they may receive. They will be asked to return this form to the HSE within two weeks. On that basis, the HSE will be able to complete all assessments by 31 December this year.

Depending on the means test, a person may qualify for a medical card, or a GP visit card, or the new health support payment of €400 for a single person, or €800 for a couple. I will now deal with the issue of the means test. The weekly income limit for a medical card will be €240.30 for a single person or €480.60 for a couple. This is the same as the highest amount of a State contributory pension following the increase in the budget. If a person's sole weekly income is €240.30 for a single person or €480.60 for a couple, or less, they will qualify for a medical card. Other social welfare payments like the fuel allowance or the living alone allowance are not counted in the means test.

If a person has a weekly income of more than €240.30 for a single person or €480.60 for a couple, they will be asked for some additional information. The means test income amount is income after expenses. Full account is taken of real expenses a person has, or can expect to have, next year. These are, for example, rent or mortgage, GP costs, medicines costs, medical appliances, nursing home fees, maintenance payments made, and any income tax or PRSI paid.

Any savings up to €36,000 for a single person or €72,000 for a couple will not be counted in the means test. The family home will not be counted in the means test.

The GP visit card entitles a person to free visits to their GP without limit. The weekly income limit will be €360.45 for a single person or €720.90 for a couple. This is 50% higher than the income limit for the medical card. If a person's sole weekly income is €360.45 for a single person or €720.90 for a couple, or less, they will qualify for a GP visit card.

Other social welfare payments like the fuel allowance or the living alone allowance are not counted in the means test. This income limit is also income after expenses. The same allowances and exemptions will apply as for the medical card means test.

A person who does not qualify for a GP visit card can still qualify for the new health support payment if their gross weekly income is less than €650 for a single person or €1,300 for a couple. The HSE will use the same means test form to assess this. There will be no need to fill in another form. The health support payment is €400 for a single person or €800 for a couple. It will be paid annually, will not require medical receipts and will not be taxable.

Medical cards and GP visit cards may still be granted by the HSE to those not qualifying on a means test on particular hardship grounds. The health levy will not be payable by people aged 70 and over. I am glad of this opportunity to be able to clarify the Government's decision on this important matter.