Dan Boyle (Cork South Central, Green Party)
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Question 120: To ask the Minister for Health and Children if her Department has calculated the cost of introducing free medical cards for both persons under six and 18 years old; the cost in both cases; and if she will make a statement on the matter. [35457/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I have asked my Department to arrange to provide the Deputy with information on the estimated cost of providing medical cards to all children aged under six years. However an exercise to establish the estimated cost will first need to be undertaken, with the assistance of the Health Service Executive, and the information sought will be provided to the Deputy as soon as possible.

In relation to the Deputy's request for an estimate of the cost of providing medical cards to persons aged under 18 years who do not currently hold a medical card, it is estimated this would cost approximately an additional €300 million per annum. This estimate has been calculated on the basis of the Central Statistics Office's national population by age estimates for 2004 and information from the Health Service Executive on the number of medical card holders aged under 18 years, as at 1st September 2006. Cost data from a number of sources has been used, in particular from the latest available 2004 Annual Report of the former General Medical Services (Payments) Board and figures provided by the HSE regarding General Medical Services (GMS) GP capitation fee payments as of 31st December 2005.

It will be noted that should eligibility arrangements be adjusted to enable larger numbers to qualify for a medical card, the actual costs arising would depend on the precise demographic profile of those additional clients. The capitation payments to GPs, for example, are calculated according to clients' age, sex and distance of their residence from the GP's centre of practice. Furthermore, the effect on the GMS drugs budget and on certain other services available free of charge to medical card holders cannot be predicted with accuracy and would be dependent on the health status of the clients concerned.

The following matters were not taken into account in arriving at the estimate of approximately €300 million:

potential additional costs in terms of income forgone by public hospitals in respect of A & E attendance and in-patient charges;

the possible cost, depending on the circumstances of the additional persons obtaining medical cards, of such services as aids and appliances and public health nursing;

any offsetting effect of a potential reduction in costs under the Drug Payments Scheme, non-medical card holders are entitled to make claims under the Drugs Payments Scheme (DPS) for reimbursement of all prescribed drugs and medicines in excess of €85 per calendar month, and persons obtaining a medical card and who currently qualify under this scheme would no longer come within the terms of the scheme, as their drug costs would be met under the GMS; and

costs in other areas of Government in which the holding of a medical card may be used as a means of determining entitlement to services or benefits.