Finian McGrath (Dublin North Central, Independent)
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Question 296: To ask the Minister for Health and Children if she will clarify the issue for families of children with downs syndrome and medical card entitlements; and if she will support the efforts of all families of children with a disability in their request for a full medical card. [12493/07]

Mary Harney (Dublin Mid West, Progressive Democrats)
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At present, medical cards are granted primarily on the basis of means and individual circumstances. Under the Health Act, 2004, determination of eligibility for medical cards is the responsibility of the Health Service Executive. Persons aged seventy years and over are automatically entitled to a medical card, irrespective of means. The HSE has discretion, in cases of exceptional need, to provide assistance to individuals where undue hardship would otherwise be caused.

Medical cards are made available to persons and their dependants who would otherwise experience undue hardship in meeting the cost of General Practitioner (GP) services. In 2005 the GP visit card was introduced as a graduated benefit so that people on low and 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.

Since the beginning of 2005 substantial changes have been made to the way in which people's eligibility for a medical card is assessed and these apply equally to the assessment process for a GP visit card. The income guidelines have been increased by a cumulative 29% and in addition allowance is now made for reasonable expenses incurred in respect of mortgage/rent, child care and travel to work costs. 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 in respect of medical cards.

I have no plans to provide for the granting of medical cards to any particular group as a whole. 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.