John Curran (Dublin Mid West, Fianna Fail)
Link to this: Individually | In context

Question 83: To ask the Minister for Health and Children her views on making an amendment to the medical card scheme whereby people in receipt of a medical card or general practitioner visit card when reaching age 66 will be entitled to keep the card permanently without any further reviews. [11120/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

The assessment of eligibility to medical cards and GP visit cards is statutorily a matter for the Health Service Executive (HSE) and, with the exception of persons aged over 70 who have an automatic entitlement to a medical card, 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, provided 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. The HSE assesses people's entitlement to these benefits on the basis of means. The assessment process also takes account of other factors which may impact on a person's ability to meet the cost of GP services. The HSE has informed me that it has detailed operational guidelines in place for the assessment and review of people's entitlement to 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 consistency of approach to means-testing nationally.

I consider it appropriate that as a matter of prudent management and governance, the Executive carries out periodic reviews of medical card and GP visit card holders in order to establish whether they continue to be eligible for these benefits. The HSE has indicated that such reviews are conducted in a manner which takes due account of the personal circumstances of the card holder and that arrangements are in place to limit the need for frequent reviews where a review would normally result in the renewal of the medical card or GP visit card, as appropriate.

John Curran (Dublin Mid West, Fianna Fail)
Link to this: Individually | In context

Question 84: To ask the Minister for Health and Children if she will make changes to the income guidelines governing the issue of medical cards and general practitioner visit cards, bearing in mind that increases in social welfare payments and general pay increases have resulted in people who previously met the criteria for a particular card now exceeding the income guidelines and not having their cards renewed. [11121/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

The assessment of eligibility to medical cards is statutorily a matter for the 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 qualifying guidelines have increased by a cumulative 29%. Assessment is now based on an applicant'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, child care and travel to work. In June 2006, there was a further increase in the qualifying 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 Social and Family Affairs payments or HSE payments, even if these exceed the stated thresholds, 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.