Joe Costello (Dublin Central, Labour)
Link to this: Individually | In context

I thank the Ceann Comhairle's office for allowing this matter to be debated on the Adjournment. I also thank the Minister for being present. It is g good to see a Cabinet Minister here at this hour of the night. He is very welcome.

I have tabled this matter to request the Minister to deal urgently with a situation that has been brought to my attention recently by a number of constituents. They have been refused medical cards for the bizarre reason that they earn too little and fall below a minimum income limit, rather than exceeding it. Not many people would believe that such an irrational situation applies.

This ruling is being applied to self-employed people, mature students on grants and people who have found for various reasons that they are not entitled to social welfare payments. To illustrate the case, I would draw the Minister's attention to two cases. First, a mature student who is a constituent of mine graduated recently from college with a first class degree. She was encouraged by the college to continue by doing Masters degree and then a PhD programme, due to her brilliance. She was hopeful of starting the Masters programme but was informed that the mature student's grant has been cut from over €6,100 to just €2,300 because from this year mature students do not have automatic entitlement to what is called the "non-adjacent rate". That excludes people living in Dublin and surrounding areas, including university towns and campuses. Of course, as mature students are not living with their parents they are not dependants either.

The mature student grant was equivalent to the supplementary welfare rate and so she had retained her entitlement to a medical card during her three undergraduate years. Now that the maintenance grant has fallen below the supplementary welfare rate, she has been informed that if she accepts the place in college on the reduced maintenance grant, she will lose her medical card. This is bureaucracy gone mad. If she refuses the college place and turns her back on the postgraduate studies, she will most likely be unemployed and will be in receipt of the job seeker's allowance. However, and this is the catch - or the benefit - she will then be entitled to a medical card. After being six months unemployed on the job seeker's allowance, she will be able to avail of the back to education allowance. When she is on the latter allowance, she will have full social welfare, the maintenance grant - albeit the non-adjacent one, which is lower - and the medical card. Of course, it will be far more expensive on the State but it will occur six months later, the course will not start for 12 months, so she will have lost a year's studies. The situation is disadvantageous for everybody in those circumstances.

This first-class honours graduate has an opportunity to progress through education and greatly enhance her employment prospects and her contribution to the State, but is now effectively being excluded from the education system. The cut in her grant means that she is being discriminated against because she is already living in Dublin. A mature student from the country could move to Dublin to study and be entitled the full grant. That is how anomalous the situation is.

The second case is of another constituent who is earning just €72 per week. He has worked since he was 15 years of age and claimed unemployment assistance for just three weeks in his entire life. He is now being told that he earns too little to be considered for a medical card as he is not, and I quote, "financially independent, with means that are within the medical card-GP-visit card guidelines. For a person to be considered financially independent, s-he must be in receipt of income equivalent to, or greater than, the current standard rate of supplementary welfare allowance". So it must be at least at the supplementary welfare allowance rate of €186, or greater. Unfortunately, the poor man is below, not above, the threshold so he does not qualify. It is ludicrous.

Apparently, the presumption is - I do not whether or not there is any truth in this, but I have heard it - that anybody earning less than the social welfare allowance of €186 could not possibly survive n that and there they must be abusing the system. The system will therefore not accept their application on those grounds.

The preservation of our citizens' health and well being must be a priority for the State. It is imperative that the operation of the medical card scheme is carried out fairly and that those most in need of health care have recourse to seeking proper medical care. The Minister should review the scheme to ensure that bureaucratic guidelines do not prevent people who are most in need of medical cards from receiving them. I call on the Minister to reverse this anomaly.

Phil Hogan (Carlow-Kilkenny, Fine Gael)
Link to this: Individually | In context

I am taking this Adjournment mater on behalf of the Minister for Health who apologise for his inability to take this matter personally. I am happy to have an opportunity to explain, as the Deputy probably already knows, how the person's eligibility for a medical card is assessed.

Joe Costello (Dublin Central, Labour)
Link to this: Individually | In context

I do indeed, Minister. I am looking for a solution.

Phil Hogan (Carlow-Kilkenny, Fine Gael)
Link to this: Individually | In context

I am interested in the examples cited by the Deputy, but I cannot give him a solution because I am not the appropriate Minister to give the discretionary information he requires. Deputy Costello has put forward an interesting number of examples which give rise to concern about the manner in which these matters are being investigated and assessed by the HSE. Applicants whose weekly incomes are solely derived from social welfare or HSE payments, even where the amounts are in excess of the HSE income guidelines, are granted a medical card, either a first application of a renewal. Where income guidelines are principal benchmark used for deciding medical card eligibility, the HSE does look beyond the applicant's financial situation and has regard to other matters that it considers appropriate in assessing a person for a medical card.

Rather than giving the Deputy the standard reply I have before me, I will ask the Deputy to furnish me with the examples he has cited this evening, including correspondence. I will then bring them to the attention of Minister of Health. I will ask him to have them fully investigated.

Joe Costello (Dublin Central, Labour)
Link to this: Individually | In context

I thank the Minister.