Brian Hayes (Dublin South West, Fine Gael)
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Question 194: To ask the Minister for Health and Children the number of discretionary medical cards distributed by the Health Service Executive per region, including eastern, midland, mid western, north eastern, north western, south eastern, southern and western; and if she will make a statement on the matter. [30551/07]

Brian Hayes (Dublin South West, Fine Gael)
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Question 195: To ask the Minister for Health and Children the number of eligible individuals and family units for discretionary medical cards by the Health Service Executive per region including eastern, midland, mid western, north eastern, north western, south eastern, southern and western; and if she will make a statement on the matter. [30552/07]

Brian Hayes (Dublin South West, Fine Gael)
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Question 196: To ask the Minister for Health and Children the number of discretionary medical cards registered on the primary care reimbursement service database; and if she will make a statement on the matter. [30553/07]

Brian Hayes (Dublin South West, Fine Gael)
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Question 197: To ask the Minister for Health and Children the amount of money paid to general practitioners for discretionary medical cards in 2007; the number of discretionary medical cards this figure is based on; and if she will make a statement on the matter. [30554/07]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 194 to 197, inclusive, together.

I understand that the Health Service Executive (HSE) has detailed operational guidelines in place for the assessment of applications for a medical card or GP visit card. The purpose of these guidelines is to ensure that every person entitled to a medical card or GP visit card is given the opportunity to avail of their entitlement and that there is a consistent approach to means-testing nationally.

The guidelines include provisions dealing with the exercise of discretion in the medical card/GP visit card application process, where an applicant would not qualify solely on the basis of an assessment of means. The term "discretionary medical card" has come to be applied to cards awarded to persons whose income exceeds the guideline figure and whose health status is such that they have greater care requirements than the average medical card holder.

In 2001, in the context of industrial relations negotiations aimed at giving effect to the extension of eligibility for a medical card to all persons aged 70 or over, it was agreed to pay additional amounts totalling €2 million per annum to contracted GMS GPs in respect of a notional figure of 20,000 "discretionary medical card" patients. The payments to individual GPs were calculated on a pro rata basis in relation to the size of each GP's GMS patient panel. In 2002, in the context of further difficult industrial relations discussions and in order to ensure the continued provision of GMS services to the eligible population, it was agreed that the pro rata payment in respect of "discretionary medical cards" would be increased such that it would be calculated by reference to an estimated population of 75,000 holders of such cards. It was contended by the Irish Medical Organisation that the number of persons with a "discretionary medical card" was in the region of 75,000 and information received by the Department from several health boards appeared to support a number of this order.

My Department and the HSE are currently working on the development of a new GMS GP contract. It is intended that the remuneration arrangements attaching to this will involve a simplification of the current arrangements, which include the capitation and a range of associated payments, including those in respect of "discretionary medical card" patients.

As aspects of the Deputy's questions relate to the management and delivery of health and personal social services, which are the responsibility of the Health Service Executive under the Health Act 2004, my Department has requested the Parliamentary Affairs Division of the Executive to arrange to address this matter and to have a reply issued directly to the Deputy.