Martin Ferris (Kerry North, Sinn Fein)
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Question 76: To ask the Minister for Health and Children if she will put in place a review of the conditions governing qualification for the medical card. [25806/07]

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 lower 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. For medical card and GP Visit Card applications, the HSE now considers an applicant's income after tax and PRSI are deducted, rather than total income. Allowances are also made for expenses on child care, rent and mortgage costs and the cost of travel to work.

Currently, my Department is preparing legislation to clarify and update existing legislation on eligibility for health and personal social services. The Bill will define specific health and personal services more clearly; define who should be eligible for what services; set out clear criteria for eligibility; establish when and in what circumstances charges may be made and provide for an appeals framework. My Department is currently examining the range of services that will be defined in legislation. It is expected that the legislation will be published in 2008.