Liz McManus (Wicklow, Labour)
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Question 309: To ask the Minister for Health and Children her views on a UN report which recommends that all children with a suitable medical condition should be granted a medical card in their own right and that the State should not seek a means test from their parents or guardians; the position where children receive medical cards; the criteria for refusal of medical cards for children, in particular in cases where they had received medical cards in the past; and if she will make a statement on the matter. [32675/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I take it the question refers to a report prepared by the Children's Rights Alliance and submitted to the United Nations Committee on the Rights of the Child as a shadow report in the context of Ireland's appearance before the Committee on 20th September, 2006.

In September, the State delegation led by Minister for Children Brian Lenihan outlined the progress that has been achieved in relation to the increased and enhanced development of policies and services for children since Ireland's last appearance before the Committee in 1998.

The Committee welcomed a number of significant developments, particularly the appointment of the Ombudsman for Children, the publication of the National Children's Strategy, the establishment of the Office of the Minister for Children and the appointment of a Minister for Children who, for the first time, sits at the Cabinet table.

In relation to the medical card and GP visit card system, the assessment of eligibility for these cards is statutorily a matter for the Health Service Executive (HSE) and is determined following an examination of the means of the applicant and his/her dependants. Under Section 45 of the Health Act 1970, medical cards are provided to persons who, in the opinion of the HSE, are unable without undue hardship to arrange general practitioner medical and surgical services for themselves and their dependants. Persons aged 70 and over are statutorily entitled to a medical card, regardless of income. In all other cases an assessment of means is undertaken.

Section 58 of the Health Act, 1970, as amended, provides for GP visit cards for adult persons with limited eligibility for whom, in the opinion of the HSE, and notwithstanding that they do not qualify for a medical card, it would be unduly burdensome to arrange GP medical and surgical services for themselves, and their dependants. The GP visit card was introduced to ensure that people on moderate incomes, particularly parents of young children, who do not qualify for a medical card, would not be deterred on cost grounds from visiting their GP. GP services provided to GP visit cardholders are the same as those provided to medical card holders.

In determining eligibility, assessment guidelines are used by the HSE. These guidelines are not statutorily binding and medical cards/GP visit cards may be granted by the HSE to persons in circumstances where the financial guidelines may be exceeded but the particular circumstances of the case warrant such a decision. Decisions to refuse an application or renewal of a medical card/GP visit card may be appealed to the Executive for further consideration.

The HSE has indicated that applications for medical cards on behalf of children with serious illnesses have been and will continue to be dealt with in as sensitive and compassionate a manner as possible. I have also been informed by the HSE that arrangements have been put in place to limit the need for frequent reviews of medical cards in cases where a review would normally result in renewal of the medical card.

I have no plans to provide for the granting of medical cards/GP visit cards to any particular population group. However, my Department is currently reviewing all legislation relating to eligibility for health and personal social services with a view to making the system as fair and transparent as possible.