Seán Crowe (Dublin South West, Sinn Fein)
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Question 602: To ask the Minister for Health and Children if the increase of €20 in the lowest rates of social welfare will affect people's eligibility for the medical card. [43789/06]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The assessment of eligibility to medical 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 1970 medical cards are provided for 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. 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. Persons aged 70 and over are statutorily entitled to a medical card, regardless of their means. In all other cases an assessment of means is undertaken.

In assessing eligibility, the HSE use guidelines based on people's means, which includes their income, certain allowable outgoings and the effect of factors such as medical need. These guidelines are not statutorily binding and a decision to refuse an application or renewal of a medical card may be appealed to the Executive for further consideration.

Applicants whose sole income is derived from Department of Social and Family Affairs payments or HSE payments, which are below or in excess of the eligibility income guidelines will be granted a medical card.

Since the beginning of 2005 the medical card assessment guidelines have been increased by a cumulative 29%. Other significant changes which I have introduced are that applications are now considered on the basis of income net of tax and PRSI and that allowance is made for reasonable expenses incurred in respect of mortgage/rent, childcare and travel to work. In June 2006, I agreed with the Health Service Executive a further adjustment to the assessment guidelines for GP visit cards and these are now 50% higher than those used in respect of medical cards.

My Department and the HSE are at present considering whether any further changes to the guidelines are required, having regard to factors such as changes in income levels generally, the nature of typical household outgoings and also changes to the various social welfare schemes.