Finian McGrath (Dublin North Central, Independent)
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Question 176: To ask the Tánaiste and Minister for Health and Children the disability categories which qualify for a medical card; the situation regarding persons with intellectual disabilities over 16 years of age; and if she will make a statement on persons with disabilities and medical cards. [7498/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Eligibility for health services in Ireland is primarily based on residency and means. Under the Health Act 1970, determination of eligibility for medical cards is the responsibility of the Health Service Executive (HSE) other than for persons over 70 who are automatically entitled to a medical card.

Medical cards are issued to persons, who in the opinion of the HSE are unable to provide general practitioner, medical and surgical services for themselves and their dependants without undue hardship. It is open to all persons, including those with a disability, to apply to the chief officer of the relevant HSE area for health services if they are unable to provide these services for themselves or their dependents without hardship.

The setting of income guidelines for medical cards is a matter for the HSE which has discretion in issuing of medical cards, and a range of income sources are excluded when assessing medical card eligibility. Despite someone having an income that exceeds the guidelines, a medical card may still be awarded if the HSE considers a person's needs or other circumstances justify this.

Persons aged 16-25, including students, who are financially dependent on their parents are entitled to a medical card if their parents are medical card holders. Those who are dependants of non-medical card holders are not normally entitled to a medical card except where they have an entitlement under EU regulations or where they are in receipt of a disability allowance.

For those who do not qualify for a medical card there are a number of schemes which provide assistance towards the cost of medication. Under the long term illness scheme, the relevant area of the HSE may arrange for the supply, without charge, of drugs, medicines and surgical appliances to people with a specified condition for the treatment of that condition. These conditions are mental disability, mental illness — for persons under sixteen -, phenylketonuria, cystic fibrosis, spina bifida, hydrocephalus, diabetes mellitus, diabetes insipidus, haemophilia, cerebral palsy, epilepsy, multiple sclerosis, muscular dystrophies, parkinsonism, conditions arising from thalidomide and acute leukaemia.

Non-medical card holders can also avail of the drugs payment scheme, which protects individuals from excessive drug costs. Under this scheme, no individual or family unit pays more than €85 per calendar month towards the cost of approved prescribed medicines.

The health strategy includes a whole series of initiatives to clarify and expand the existing arrangements for eligibility for health services including recommendations arising from the review of the medical card scheme carried out by the health board CEOs under the Programme for Prosperity and Fairness.

The Programme for Prosperity and Fairness also contained a commitment that a working group be established to examine the feasibility of introducing a cost of disability payment. This working group is to conduct a review of medical card entitlements for people with disabilities.

Brian O'Shea (Waterford, Labour)
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Question 177: To ask the Tánaiste and Minister for Health and Children the reason the number of medical cards in the South East Region has fallen from 39,508 in January 1997 to 34,969 in mid-February 2005; and if she will make a statement on the matter. [7508/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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Generally, the reduction in recent years in the number of medical cards may be attributed to the increase in the number of people in employment and the improved economic situation nationally. Another factor which affects this area is the ongoing review by the Health Service Executive of medical card databases, which has led to deletions of medical card records due to duplicate entries, change of address, cases where the medical card holder is deceased, ineligibility due to changed circumstances and ongoing normal reviews.

The determination of eligibility of applications for medical card is a matter by legislation for the chief officer of the relevant area of the Health Service Exeuctive. In determining eligibility, the local area of the Health Service Executive will have regard to financial circumstances and medical needs of the applicant. A medical card will be issued to a person, for whom, in the opinion of the chief officer, the provision of medical services for him/herself and, or, their dependants would cause undue financial hardship.

In November of last year I increased the medical card income guidelines, by 7.5 % for determinations of full eligibility, together with significant rises in respect of dependants with a view to extending the number of medical cards by 30,000 in 2005. These guidelines are in operation since January 2005. The introduction of the doctor visit card will extend eligibility to a patient holding a doctor visit card, to general practitioner services under the general medical services scheme. These patients' income can be up to 25% in excess of the income guidelines used for the assessment of full eligibility. The legislation required to enact this is currently going through the Seanad. It is hoped that a further 200,000 persons will become eligibile for GP services in 2005 as a result of this measure.

My Department has requested the chief officer of the Health Service Exeuctive, south eastern area to investigate this matter and to reply directly to the Deputy.