Seán Power (Kildare South, Fianna Fail)

The House will never have heard enough from Senator Henry. It is always nice to have the contribution of someone involved at the coalface of the issue.

Senator Browne's amendment seeks to require the Minister to issue guidelines to specify the criteria to be used in deciding whether a person meets the test set in section 58(1)(b) of the Health Act 1970. Upon the passage of the Bill, that section would establish the principle that the term "unduly burdensome" represents a lesser degree of difficulty than the term "undue hardship", which is the basic test for the standard medical card. As indicated previously, the Department has conveyed to the Health Service Executive the Tánaiste's wish that it should base its initial guideline on a 25% increase of the income limits in force for the standard medical card. This guideline can be revised if the anticipated number of people does not qualify or take up the new cards.

The medical card scheme has operated under the Health Act 1970 on the basis that decisions on undue hardship are taken at the individual health board level. The income guidelines governing these decisions were agreed by the CEOs of the health boards while the operational agreements of the doctor-visit medical card scheme are currently being drawn up between the HSE and the IMO. To introduce a system of ministerial guidelines would represent a fundamental alteration of the basis on which the medical card scheme operates. I am not, therefore, in a position to accept the amendment.