James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Question 206: To ask the Minister for Health and Children the means test assessment guidelines for the over 70s medical card (details supplied); and if she will make a statement on the matter. [37882/08]

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Question 207: To ask the Minister for Health and Children if illegal nursing home charges repaid by the State will be considered as income or savings under the revised over 70s medical card scheme; and if she will make a statement on the matter. [37883/08]

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

I propose to take Questions Nos. 206 and 207 together.

The Government recently announced the introduction of new income thresholds for entitlement to a medical card for those aged 70 and over of €700 (gross) per week for a single person and €1,400 (gross) per week for a couple with effect from 1st January 2009. In addition, it is proposed that:

Any savings up to €36,000 (single) / €72,000 (couple) will be disregarded and only interest from savings above these figures will be considered as income for means testing purposes.

Income will not be imputed from property (whether a family home, a holiday home or any other property) for means testing purposes, unless it is rented and only the net rental income will be included as income. The income to be assessed will be the gross income, less any cost necessarily incurred associated with the property and such cost may include insurance premia, loan/mortgage repayments, maintenance, etc.

Only dividend payments will be considered as income for means testing purposes in the context of shares and investments.

Where a person receives money as a gift, only the interest which such monies earn will be taken into account and not the capital.

It is intended to disregard income from prescribed repayments made under Section 8 of the Health (Repayment Scheme) Act 2006. The detailed arrangements to provide for this will be finalised shortly.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Question 208: To ask the Minister for Health and Children the cost to administer the means test for the over 70s medical card; and if she will make a statement on the matter. [37884/08]

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

The Government recently announced, as part of its budget proposals, the withdrawal of automatic entitlement to the medical card from people aged 70 years and over and the introduction of new income thresholds for entitlement to a medical card for those aged 70 and over of €700 (gross) per week for a single person and €1,400 (gross) per week for a couple. Legislation, which will give effect to these changes, will be enacted before the end of 2008 and will come into effect on 1st January 2009.

The arrangements set out in the legislation will provide that persons aged 70 and over who automatically acquired their medical card on age grounds before 31st December 2008 will self-assess for medical card eligibility. In the case of persons reaching age 70 on or after 1 January 2009, the intention is that they would be required to apply formally for a medical card, to confirm in their application that their income is below the specified limits and to provide appropriate supporting evidence. The legislation will include appropriate provisions in relation to validating the initial self-assessments and the eligibility of those granted medical cards in future under the new arrangements. It is not possible at this time to estimate the cost of administering these arrangements but full regard will be had to the need to balance cost-effectiveness and probity in the use of public funds.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Question 209: To ask the Minister for Health and Children the status of the saver clause detailed in section 7 of the Health Service Executive medical visit card national assessment guidelines; and if she will make a statement on the matter. [37885/08]

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

Chapter 7 of the Health Service Executive's (HSE) Medical Card / GP Visit Card National Assessment Guidelines states the following:

"As a matter of policy, which can be altered at any time, and in the interest of fairness the following shall apply:

If a person who previously qualified for a Medical Card / GP Visit Card and on subsequent review finds that s/he is no longer eligible due to a policy change in relation to certain disregards of income and/or other policy changes, such Medical Cards / GP Visit Cards will be renewable for a once off period of 3 years from the date of renewal. The decision maker should notify the person at that stage that the card will be renewed for 3 years and thereafter the Saver Clause will no longer apply and s/he must be assessed under the guidelines applicable at the time".

I am advised by the HSE that the assessment guidelines were issued to promote consistency and fairness in deciding eligibility throughout the HSE. In that context an administrative decision was taken by the HSE to insert a 'saver clause' to support the transitional implementation of the guidelines and the delivery of consistent decision making and a standardised appeals system. The HSE has advised that the Assessment Guidelines only refer to operational policies as set down by the HSE. The 'saver clause' is not intended to deal with statutory changes to the scheme, as this is not within the competence of the HSE.

The HSE has also confirmed that when it inserted the "saver clause" in its assessment guidelines, it was not its intention that it would apply to non means tested medical cards, such as card holders aged 70 and over and EU cases, as the HSE would not have been reviewing the eligibility of this cohort of people.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Question 210: To ask the Minister for Health and Children the estimated saving from the withdrawal of the over-70s medical card scheme, excluding savings anticipated from the single general practitioner capitation rate and potential savings from drugs costs; and if she will make a statement on the matter. [37886/08]

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Question 211: To ask the Minister for Health and Children the estimated saving from the introduction of a single general practitioner capitation rate; and if she will make a statement on the matter. [37887/08]

Seán Barrett (Dún Laoghaire, Fine Gael)
Link to this: Individually | In context

Question 272: To ask the Minister for Health and Children the details of the savings that are expected to be realised by the removal of the automatic entitlement to a medical card for persons over 70 years; the way the figure of 5% of older people losing their cards was arrived at; and if she will make a statement on the matter. [38422/08]

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

I propose to take Questions Nos. 210, 211 and 272 together.

Following the recent Government decision to withdraw automatic entitlement to a medical card for persons aged 70 and over and to raise the means assessment threshold for persons in that age cohort, it is estimated that approximately 5% (20,000) of the current medical card holders aged 70 and over will no longer qualify for a medical card. It is estimated that this will result in a saving of approximately €20 million in 2009, taking account of GP capitation fees, drug costs, superannuation costs, etc. The estimate of 5% of persons aged 70 and over, who will lose automatic entitlement to a medical card as a result of this measure, was based on the best available information from the Central Statistics Office (CSO) and the EU wide Survey on Income and Living Conditions (EU-SILC), which is conducted by the CSO to obtain information on the income and living conditions of different types of households.

In relation to the introduction of a single GP capitation rate, the Government appointed Mr. Eddie Sullivan to make recommendations on a new single annual capitation fee to be paid to general practitioners in respect of medical card holders aged 70 and over in the community. Mr. Sullivan recommended a single capitation fee of €290, which would come into effect, subject to the proposed legislative changes, from 1st January 2009. Mr. Sullivan's recommendations were accepted by Government last week. Mr. Sullivan estimated that this would generate savings of the order of €16 million in 2009.

The Government believe that there is potential for significant savings of at least €64 million in drug costs, without compromising on patient care. Accordingly, it has decided to establish a process under the chairmanship of Dr. Michael Barry, to develop recommendations for good practice which will secure safe and effective prescribing for patients, while maximising the potential for economy in the use of public funds. The initial report from Dr. Barry will be prepared by 1st December 2008. The Government is satisfied that there is significant potential for savings arising from this prescribing initiative.