Ciarán Cannon (Galway East, Fine Gael) | Oireachtas source

I am taking this matter on behalf of my colleague, the Minister of State at the Department of Health with responsibility for primary care, Deputy Alex White and I thank the Senator for raising it. As the Senator pointed out, changes were made earlier this year to the medical card means test and to the income thresholds for over 70s medical cards. Those changes were made on foot of budget 2013 which identified a wide range of savings that were required across the health services. The General Medical Services, GMS, scheme was one of a number of areas identified in which savings were required.

A number of measures are being taken to reduce the cost of the GMS, which costs approximately €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 approximately 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. It should be noted that the overwhelming majority of medical cardholders aged over 70 years are unaffected by that change. For the wealthiest 5% who 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 2013 to give effect to the revised eligibility arrangements. Last December, at 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 Senator referred to this in his contribution.

The changes recently introduced by the Health Service Executive 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 onwards.

For clarity, 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 Senator may 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 would like to assure him 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 to fully take account of a person's mortgage or rental expenses. In addition, other allowable expenses were protected budget 2013. The need to reduce the income limits for medical cards was avoided in budget 2013.