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Dáil
‹ Ceisteanna—Questions . Oral Answers . - Health Services Eligibility .

Costs of health-service eligibility tests

Summary

The Minister said the costs of administering the various means tests could not readily be quantified because they fell across many agencies. He acknowledged that eligibility arrangements were unsatisfactory and promised improvement through the pay-related scheme, defending selective, means-tested access where resources are limited; Dr. Browne challenged the lack of cost assessment and argued that broader wealth distribution would provide sufficient resources.

asked the Minister for Health the total costs, in all its aspects, of administering the various permutations of the means test for determining eligibility for the health services.

Comment on this

: It would be difficult to quantify these costs as they fall on a large number of agencies and concerns.

Comment on this

: Is this not one of the great points against the kind of service in which the Minister believes, the multiplicity of eligibility criteria? Is it not the job of a responsible Minister, before he recommends to Parliament a particular kind of service, to know the financial implication of that kind of service, the means test one, which was a very important criterion for me in relation to whether or not I would have a means type test service and for most people concerned? Is the Minister not interested in the fact that the implementation of the various limited eligibility clauses would be a very costly procedure in administrative terms?

Comment on this

: I do not think it is fair for the Deputy to say I am not interested.

Comment on this

: Interested enough to find out.

Comment on this

: The general position is that I hope to effect a very considerable improvement in this whole area with the introduction of the pay-related scheme next April. However, the Deputy should bear in mind that selectivity in the administration of the health services is thought desirable by many people. In fact, I think the socialist viewpoint in recent years was very much adherence to the idea of selectivity and, of course, selectivity means a means test.

Comment on this

: Would the Minister not agree that, if he is proposing to improve the administration of the health service, he knows it has to be improved? Why would he improve a service which is all right? Does he know whether it is all right? How can he know that unless he assesses it?

Comment on this

: I know that on the question of eligibility for health services generally the situation is not satisfactory. I admit that, but I hope to effect a considerable improvement next April with the introduction of the pay-related insurance and health contribution. I must repeat to the Deputy that in this area the arguments for and against selectivity based on a means test are open and shut. If I have limited resources and I can introduce improvements on the basis of selectivity only, surely I should bring them in for people most in need of them even if it involves selectivity and a means test.

Comment on this

: What about the wealth tax?

Comment on this

: Would the Minister not agree that the only reason he considers he has limited resources is that the limited resources are restricted to a minority of the population and if there were proper distribution of wealth in this society there would be plenty of money to go around?

Comment on this
Joseph Brennan An Ceann Comhairle Fianna Fáil

: We are having argument now which does not arise.

Comment on this

: Some day the Deputy and I may agree on all these fundamental matters.

Comment on this