Mary Upton (Dublin South Central, Labour)
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Question 191: To ask the Minister for Health and Children if she is satisfied that the limits applied for eligibility for the medical card and the general practitioner visit card are realistic in view of the spiralling cost of living at present; and if she will make a statement on the matter. [10040/08]

Joe Costello (Dublin Central, Labour)
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Question 214: To ask the Minister for Health and Children when the means threshold for the medical card was last increased; when it is proposed to increase the means threshold again; the number of medical card holders who have lost the medical card as a result of the failure to increase; and if she will make a statement on the matter. [10210/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 191 and 214 together.

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 Act 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 income. In all other cases an assessment of means is undertaken.

In recent years there have been significant improvements to the way in which people's eligibility for medical cards and GP visit cards is assessed. Since the beginning of 2005, the qualification guidelines have increased by a cumulative 29% (7.5% and 20% in January and October 2005 respectively). Assessment is now based on a person's and, where relevant, his/her spouse's income after tax and PRSI, and takes account of reasonable expenses incurred in respect of rent or mortgage payments, childcare and travel to work. In June 2006, there was a further increase in the qualification threshold for the GP visit card to 50% above that for a medical card. Furthermore, under the assessment guidelines, persons whose weekly incomes are derived solely from Department of Social and Family Affairs payments or HSE payments, even if these exceed the stated threshold, qualify for a medical card.

The Programme for Government commits to the following:

Indexing the income thresholds for medical cards to increases in the average industrial wage;

Doubling of the income limit eligibility of parents of children under 6 years of age, and trebling them for parents of children under 18 years of age with an intellectual disability.

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. As part of this exercise, a review of the eligibility criteria for medical cards in the context of financial, medical and social need is being undertaken and is expected to be completed by autumn 2008. When that review is completed, it is my intention to consider how best to progress the commitments in the Programme for Government in relation to medical card eligibility.

Details of the numbers of medical card holders are provided to my Department each month by the Health Service Executive. The figures are provided on a net basis showing the balance after new cards have been issued and other cards, as appropriate, have been deleted from the Executive's database, e.g. following a review of a person's circumstances. These figures show that 1,280,510 persons held a medical card in February, 2008, compared to a figure of 1,145,083 card holders in January, 2005. This represents a net increase of 135,427 medical card holders.