Joe Costello (Dublin Central, Labour)
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Question 213: To ask the Minister for Health and Children the reason homeless people are denied the medical card; the number of homeless applicants who have been refused the medical card in each of the past five years because they have no fixed abode; if she will put in place a mechanism to enable homeless people to avail of their entitlement; and if she will make a statement on the matter. [10209/08]

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 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 their means. In all other cases an assessment of means is undertaken.

In assessing eligibility, the HSE uses guidelines based on people's means, which includes their income, relevant outgoings and the effect of factors such as medical or social need. 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.

Medical cards are available to homeless persons on the same basis as to any other member of society. Nonetheless, I am aware of the particular issues which can make it more difficult for homeless persons to interact with the HSE in relation to their eligibility for a medical card. In this regard, I have been informed by the HSE that, although cognisant of the need to maintain an accurate GMS database, it recognises the need to have appropriate processes in place to address particular issues which arise in relation to medical cards for homeless persons. The Executive has indicated that it is working to improve the operation of the medical card application and review processes insofar as these relate to homeless persons, with specific arrangements in relation both to new applicants and the renewal of existing cards.

Details of the number of medical card holders are provided to my Department each month by the HSE. The figure is 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. Accordingly, details on the number of medical card applications from homeless persons are not routinely provided to my Department.

As the Health Service Executive has the operational and funding responsibility for these benefits, it is the appropriate body to consider the issue raised by the Deputy in relation to medical card applications from homeless persons. My Department has therefore requested the Parliamentary Affairs Division of the Executive to arrange to address this matter and to have a reply issued directly to the Deputy.