Seanad debates
Wednesday, 27 September 2023
Nithe i dtosach suíonna - Commencement Matters
Medical Cards
10:00 am
Maria Byrne (Fine Gael)
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I thank the Minister of State for coming to the House to discuss this important issue. I was contacted by a number of people, mainly those aged over 75 and who have certain illnesses and are on medication, who are affected by the requirement to have a medical certificate in order to renew their driving licences, the cost of which is not covered under the medical card scheme.
Many have to renew their licences every three years because that is the rule. In one case, somebody paid €65 to renew a licence, and will have to pay €65 every three years. The Government gave those aged over 70, as well as people with illnesses and special disabilities, medical cards. It is not their fault that they have to get these certifications, the cost of which is not covered under the medical card scheme. I have raised this issue on previous occasions and it did not go anywhere, but it is something that needs to be considered because a huge cohort of people are affected by this. It is not fair that they have to pay anything between €50 and €65 every three years for a medical certificate.
Josepha Madigan (Dublin Rathdown, Fine Gael)
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I thank the Senator for raising this matter and I appreciate she has raised it in the past. The Health Act 1970 provides that persons who are unable, without undue hardship, to arrange GP medical services for themselves and their family can qualify for a medical or GP visit card. The Senator is obviously aware of that. These services are provided for under the general medical services, GMS, scheme through which the HSE contracts GPs to provide medical services to medical and GP visit card holders.
Under the terms of the current GMS contract, GPs are required to provide eligible patients with all proper and necessary treatment of a kind usually undertaken by a general practitioner and not requiring a special skill or experience of a degree or kind which general practitioners cannot reasonably be expected to possess. The HSE reimburses GPs for services provided under the GMS contract and medical and GP visit card holders are not subject to any charges in respect of such medical services, including the cost of GP consultations.
The contract stipulates that fees in respect of certain medical certificates which may be required, for example, under the Social Welfare Acts or for the purposes of insurance policies or the issuing of driving licences, are not covered by the contract. Obviously, the Senator is already aware of that. GPs are private practitioners. Accordingly, any fees charged by them for services provided outside of the terms of the GMS contract are a matter of private contract between the GP and their patients. It seems that is the area that should be concentrated on. This includes medical reports required for driver licence applications.
The requirements for the submission of a medical report from a registered medical practitioner with driving licence applications for certain categories of persons, including those aged 75 and over, is governed by the National Driver Licence Service, NDLS, and the Department of Transport. There are no plans, I understand, to include the completion of medical reports required for driving licence applications as a service to be provided to GMS patients by GPs under the GMS or GP visit card schemes which focus on services for the treatment of patients.
Nevertheless, I can see what the Senator is talking about when she mentioned the fact that the cost is quite prohibitive. The matter of a charge of €65, in particular in the case of a licence renewal every three years, is something I can bring back to the Department and Minister. I thank her for her contribution today.
Maria Byrne (Fine Gael)
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I thank the Minister of State. I know it is not her area of responsibility, but it is disappointing to hear the response from the Department of Health, on behalf of the Minister for Health, Deputy Stephen Donnelly. We are all aware that the cost of these certificates is not covered under the scheme. That is the whole point. To be given the facts of what the Act is about and what the scheme covers is disappointing.
I appreciate the fact that the Minister of State will bring this matter back to the Minister. It is an area that needs to be looked at. It is unfair that some have to pay these charges, in particular those aged over 75 or those with a disability. We are all talking about equality of service and the Minister of State is doing great work in terms of people with disabilities and special needs. I am sure she fully understands exactly where I am coming from. I would like her to bring this matter back to the Minister, with a caveat that he should consider this in terms of budget 2024.
Josepha Madigan (Dublin Rathdown, Fine Gael)
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Again, I can bring the Senator's representation on including this in budget 2024 to the Minister. From a humane perspective, there is huge merit in what the Senator has said. My understanding, from the statement today, is that the Department is bound by the GMS contract and the fact that GPs are private practitioners, most of whom hold a GMS contract with HSE for the provision of GP care without charges for medical and GP visit card holders.
The scope of services under the contract does not include all services that may be provided by general practitioners. As the Senator said, she is aware of all of this.. She is bringing this matter to the attention of the Seanad and me, in my capacity as Minister of State with responsibility for special education.I can bring back that to the Department and the Minister. The fact that Senator Maria Byrne brought it up in the past as well may have some value.